System and apparatus for item management

ABSTRACT

Item-management systems, apparatus, and methods are described, preferably for management of items such as medicaments. In embodiments, an item-management system comprises a container defining plural cells, a docking station configured to receive the container, sources of visible information to indicate the cell(s) into which an item is to be loaded, and at least one controller operable to control the visible information sources to indicate the cell into which the item is to be received.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of and claims priority to U.S. patentapplication Ser. No. 15/610,083, filed May 31, 2017, now U.S. Pat. No.10,650,921, issued May 12, 2020, which is a continuation of and claimspriority to U.S. patent application Ser. No. 13/841,724, filed Mar. 15,2013, now U.S. Pat. No. 9,672,327, issued Jun. 6, 2017, which is acontinuation-in-part of U.S. patent application Ser. No. 13/766,092,filed Feb. 13, 2013, now U.S. Pat. No. 9,002,510, issued Apr. 7, 2015which is a continuation of U.S. patent application Ser. No. 12/033,957,filed Feb. 20, 2008, now U.S. Pat. No. 8,380,346, issued Feb. 19, 2013.U.S. patent application Ser. Nos. 13/841,724, 13/766,092 and 12/033,957are incorporated herein by reference in their entirety to providecontinuity of disclosure.

FIELD

The field relates generally to item management and, more particularly,to item management providing for improved efficiency in itemdistribution.

BACKGROUND

Personnel involved in handling of items are routinely required to manageand organize the items for delivery to an appropriate user or process.An item as used herein, means or refers to a separate article, object,or product. Care is required to ensure that the correct item isdelivered to the user or process. Examples of such item-management tasksinvolve handling of medicament or nutriceutical items ultimatelyintended for use by a patient, consumer, or other user. A medicamentmeans or refers to a medication product while a nutriceutical canrepresent a dietary supplement which provides health or medicalbenefits. (e.g., a vitamin, a mineral, or a supplement.)

Items such as medicaments and nutriceuticals are provided in variousphysical forms, such as solid or substantially solid forms, granularforms, gel forms, and liquid forms. Solid or substantially solidmedicament and nutriceutical items may be shaped into small solidtablets in the physical form of capsules, spheres, ovals, disks,multi-angles, squares, triangles, and ellipses. Gel, granular, orliquid-form items may be packaged in the form of small capsules and gelcaps (for oral consumption), or ampules containing a liquid. Medicamentand nutriceutical items may also be provided which differ in strength ofthe active chemical constituent. For example, a single medicament ornutriceutical item may be provided with a concentration of 1, 5, or 10milligrams of the active chemical constituent.

One way in which the foregoing types of items are managed for deliveryto the ultimate user is through automated dispensing machines. Automateddispensing machines are frequently utilized by pharmacies, hospitals,long-term care facilities, and others in the health-care field forpurposes of automatically dispensing medicaments required to fulfillpatient prescription orders and to dispense medicaments administered topatients in hospitals and long-term care facilities, such as nursinghomes. Automated dispensing machines can also be used in retaildistribution, such as to dispense nutriceutical or food items. Suchautomated dispensing machines are computer controlled to dispense anappropriate quantity of medicaments and, typically, to package themedicaments. And, automated dispensing machines can typically beprogrammed to dispense and package all medicaments required to fulfillall prescription orders and dispense requests for a given eight-hourwork shift. The automated dispensing machine will proceed toautomatically execute the instructions until all requested medicamentshave been output.

Automated dispensing machines typically store and dispense a pluralityof different medicament types. Medicaments which are frequentlyprescribed or utilized, referred to as “fast-moving” medicaments, arestored within the automated dispensing machines in large quantities asloose, bulk form items within cassettes, cells, canisters, magazines,racks, or other storage apparatus. A single medicament type is stored ineach storage apparatus.

Medicaments which are less frequently prescribed or utilized arereferred to as “slow-moving” medicaments. Medicament types which areinfrequently required may be stored in the automated dispensing machinein what is referred to as an “exception storage apparatus,” a type ofstorage apparatus which derives its name merely from being analternative to the medicament storage apparatus used for the fastermoving medicaments. Slow-moving medicaments could include medicamenttypes with unusual chemical constituents or with unusualactive-constituent concentrations. An exception storage apparatus storessmall quantities of the less-frequently used medicaments which could notbe efficiently stored in large bulk quantities. Unlike the cassettes,cells, canisters, magazines, racks, or other storage apparatus for thefaster moving medicaments, more than one medicament type can be storedin a single exception storage apparatus.

An exception storage apparatus can be provided, for example, as adrawer, or as a tray-like device, which pulls out from the automateddispensing machine and which includes a plurality of medicament-holdingcells, or compartments, for holding one medicament item or a smallquantity of medicaments. In certain automated dispensing machine types,the cells of the exception storage apparatus are movable along a track.The cells can be indexed forward along the track toward an opening sothat the cell contents fall serially (i.e., one-after-the-other) througha cell bottom opening for packaging by the machine. Any number of cellscan be provided in the exception storage apparatus. For example, anexception storage apparatus could include 64 total cells grouped in fourrows of 16 cells all movable along the track. More than one exceptionstorage apparatus may be provided.

The exception storage apparatus offers the operator an opportunity toincrease the range of dispensing options because more than one type ofmedicament can be stored in such storage apparatus. For example, themedicaments can be arranged in the exception storage apparatus todispense medicaments for a particular patient according to the order inwhich the medicaments are to be taken by the patient (e.g., breakfast,lunch, and dinner) or can be loaded to meet the medicament requirementsof more than one patient.

Upon activation, the automated dispensing machine automatically metersout from the appropriate storage apparatus the desired quantity ofmedicament(s) called for by the prescription order or dispense request.The medicament item or items are directed from the storage apparatus tothe packaging apparatus by means of gravity through a chute or otherguide apparatus, or by mechanical means such as an auger. The packagingdevice may then load the dispensed medicaments into one or morepackages. The type of package utilized is based on the capability of theparticular type of automated dispensing machine. By way of example only,automated dispensing machines may load the medicaments into containerssuch as vials, bottles, blister packages, or pouch packages. Themedicament or medicaments, once packaged in the container type utilizedby the automated dispensing machine, may then be delivered to thepatient or other designated user.

Loading or replenishment of the cassettes, cells, canisters, or otherstorage apparatus for the fast moving medicaments is relatively easy.All that is required is placement of a loaded storage apparatus into themachine (e.g., in place of a depleted storage apparatus) or the pouringof a quantity of the bulk-form medicaments into a depleted storageapparatus.

However, loading or replenishment of the cells or compartments of theexception storage apparatus is more problematic because a human beingmust manually load or replenish the cells or compartments. In apharmacy, hospital, or long-term care facility, the human is a pharmacytechnician or a registered pharmacist. The technician or pharmacist mustmanually load the medicament items directly into the exception storageapparatus cells. Alternatively, the medicament items can be placed intothe cells of a “loading device.” A loading device is a device with cellsor compartments that correspond to the cells of the exception storageapparatus. The loading device can be loaded at a workstation and carriedto the automated dispensing machine so that the medicament contents ofthe loading device can be transferred into the appropriate cells of theexception storage device. By way of example only, a busy pharmacy mightuse dozens of different loading devices to load the exception storageapparatus during a given work shift.

The exception storage apparatus loading process is tedious and timeconsuming, irrespective of whether the medicament items are placeddirectly into the exception storage apparatus cells or are placed intothe cells of a loading device for transfer to the exception storageapparatus. As can be appreciated, the loading process must be undertakenin a deliberate and considered manner to ensure that the correctmedicament is placed in the correct cell or compartment. Placement ofthe correct medicament in the correct cell or compartment can bedifficult because the cells or compartments of a typical exceptionstorage apparatus or loading device are relatively small and are inclose proximity to each other. The chance of an inadvertent error may beincreased because certain medicaments have similar shapes, sizes, andappearances.

Typically, printed paper instructions are generated which direct thetechnician or pharmacist to place the required medicament into adesignated cell or compartment. At a minimum, valuable time is requiredto follow the instructions. The instructions may require complexordering of different medicament types among the cells raising thepossibility, no matter how slight, that the wrong medicament could beplaced in a cell or compartment. And, because the technician orpharmacist must take her eyes off the exception storage apparatus orloading device to read the instructions, and because the cells typicallylook alike, there is also a slight possibility that the wrong medicamentitem could be placed in the cell. And, since more than one loadingdevice could be used by a pharmacy, there is a possibility, no matterhow remote, that an incorrect loading device could be used to load theexception storage apparatus.

If a pharmacist is required to inspect a loading device or exceptionstorage apparatus before use to verify that the medicaments were loadedcorrectly, then the pharmacist must essentially repeat the loadingprocess to confirm that the correct medicament was received in thecorrect cell.

A skilled pharmacist's time is extremely valuable. Time spent loading anexception storage apparatus is time that could be spent counselingpatients. And, an automated dispensing machine must typically bedeactivated or taken “off line” in order to load the exception storageapparatus. Any time spent loading an exception storage apparatus canrepresent lost productive time in which the automated dispensing machinecannot be used to fulfill prescription orders or dispense requests,thereby decreasing efficiency and increasing costs to the operator.

Problems similar to those described for operators of automatedmedicament dispensing machines can exist for operators of other types ofautomated dispensing machines in which both fast and slow moving itemsmust be dispensed from a single machine. For instance, the same issueswould face the operator of an automated dispensing machine used todispense nutriceutical products or other retail food products.

Problems identical to those described above exist with respect toloading of medicaments and other items into other types of containerswith plural cells or compartments, particularly if different types ofmedicaments or items are to be loaded into the same container. Blisterpackages represent such a container into which plural medicaments oritems may be loaded. A blister package is a type of pre-formed containerused for holding medicaments, nutriceuticals, or other small goods anditems.

The primary component of a blister package is a plurality of cells madefrom a thin web of formable material. Any number and arrangement of thecells can be provided. Each cell has an upper opening through which oneor more item is placed in the cell. A closure of paperboard, or a sealof aluminum foil or plastic may be placed over all of the cells to closethe blister package container. The closed blister package container isthen ready for delivery to the patient.

Certain blister packages are referred to as push-through-packs. In apush-through-pack, the material in which the cells are formed iscollapsible by pushing with a human finger. The seal is breakable sothat the item within the cell can be pushed through the seal and out ofthe blister package container for use.

Blister packages may be used as compliance containers by printing thedays of the week above each cell. Such an arrangement ensures that themedicaments may be taken one-after-another at the correct date and time.

A disadvantage of blister packages is that they cannot be easily used ascompliance containers if more than one type of medicament is required tobe in the container. This is because the blister package is typicallyloaded with the same type of medicament by means of a form-fill-sealmachine.

To load the blister package with different types of medicaments in anorder in which the medicaments are to be taken would requirehand-loading by a human. Such a process would require use ofinstructions to determine which cell a medicament is to be placed into.Repeated manual tasks of hand-loading would be required to loaddifferent types of medicaments in a single blister package. From a humanfactors standpoint, such a process would be tedious and subject topotential error. Errors could occur, for example, because of the numberof repetitive actions required, the look-alike nature of medicament-typeitems, and the look-alike nature of the cells. Any error in loading oneor more cells of the blister package, for example with the wrongmedicament, or the wrong medicament for the date and time ofadministration, could harm the patient and must be avoided.

An additional problem with any repetitive hand-loading of any container,including the aforementioned “loading devices” and blister packages, isthe lack of any positive feedback confirming that the medicament orother item has been loaded into the correct cell. The aforementionedcontainer-loading systems lack any type of feedback to instantaneouslyconfirm and verify that the correct medicament or other item has beenplaced into the correct cell. Providing such feedback could help assurethat the correct medicament is provided for the patient, thus overcomingsome of the human-factors limitations of any hand-loading operation.

There is a need for an item-management system, apparatus and methodswhich would improve the item management and distribution process, whichwould facilitate more accurate item management and distribution, andwhich would reduce the time needed to manage items, thereby freeingpersonnel for other important tasks and improving the quality of carewhich can be offered.

SUMMARY

Item-management systems, apparatus and methods are described. Thesystems, apparatus, and methods facilitate management and organizationof items, such as medicaments. The systems, apparatus, and methods maybe used, for example, to ensure that the correct item is provided to auser or other process.

The systems, apparatus, and methods are described in the preferredcontext of management of medicament-type items but can have applicationwith respect to management of other items, such as nutriceuticals.

In embodiments, a medicament-management system is provided. The systemenables a pharmacy user to rapidly and accurately load medicamentcontainer cells with medicaments. The loading is preferably performed byhand-loading. A system may include one or more portable medicamentcontainers, a docking station, indicators or visible information sourceswhich communicate visible information to a user, and at least onecontroller.

In embodiments, the containers are portable medicament containers. Eachcontainer preferably has plural cells and each cell has a cell upperopening through which a medicament is hand-loaded. In an embodiment, thecontainers are used to transfer medicaments to an automated dispensingmachine. In other embodiments, the container or containers may beblister packages.

In embodiments, a container may be temporarily docked at the dockingstation while being hand-loaded. A second of the containers istemporarily docked after the first container is removed from the dockingstation. The docking station may include circuitry enabling control ofvisible information proximate the cells indicating “yes” and “no” statesof the cells.

If the container is a blister package, it is preferred that the dockingstation include structure into which the blister package nests whendocked. In embodiments, the docking station may include cell-receivingpockets which receive the blister package cell walls to enable thenesting. Nesting may provide improved support for a container of ablister-package type.

In embodiments, the indicators communicate the visible information tothe user. The “yes” state information indicates the cell into which themedicament is to be loaded. In embodiments, the visible information maybe viewable directly on the docked container proximate the cells. Incertain embodiments, the indicators may include light pipes. Theindicators may radiate light. The indicators may include an energizablelight source. The light source may be multi-colored and there may beplural indicators associated with each cell of the docked container.

In embodiments, a sensor guide may be provided to detect passage of amedicament toward a cell. A preferred sensor guide may be associatedwith the docking station and operably connected to the at least onecontroller. The sensor guide may having plural openings with an openingbeing associated with each cell. The detection may be implemented todetect whether the medicament is placed into an expected cell. The atleast one controller may generate a signal alerting a user to a possibleerror if the medicament is placed in other than the expected cell.

BRIEF DESCRIPTION OF THE DRAWINGS

Exemplary item-management systems, apparatus, and methods may beunderstood by reference to the following description taken inconjunction with the accompanying drawings, in which like referencenumerals identify like elements throughout the different views. Forconvenience and brevity, like reference numbers are used for like partsamongst the embodiments. The drawings are not necessarily to scale,emphasis instead being placed upon illustrating the principles of theinvention. In the accompanying drawings:

FIG. 1 is a perspective view of a representative holder docked at adocking station;

FIG. 2 is a schematic side sectional view of the representative holderand docking station taken along section 2-2 of FIG. 1;

FIG. 3 is a schematic top sectional view of a representative holderdocked at a docking station taken along section 3-3 of FIG. 1 withcertain holder portions cut away to facilitate understanding;

FIG. 4 is a top side view of the representative holder of FIG. 1;

FIG. 5 is a left side elevation view of the representative holder ofFIG. 1;

FIG. 6 is a schematic top sectional view of a representativewireless-type holder docked at a docking station taken along a section,such as section 3-3 of FIG. 1 with certain holder portions cut away tofacilitate understanding;

FIG. 7 is a perspective view of a further exemplary embodiment showing adocking station with a guide, and a holder docked at a docking station;

FIG. 8 is a schematic side sectional view of the further exemplarydocking station and guide taken along section 8-8 of FIG. 7;

FIG. 9 is a schematic top sectional view of the further exemplarydocking station and guide taken along section 9-9 of FIG. 7;

FIG. 10 is a top side view of the holder shown in FIGS. 7-9 shown apartfrom the docking station;

FIGS. 11A-11C are enlarged fragmentary views of region 11 of FIGS. 3, 6,and 9 provided to illustrate an alternative indicator embodimentcomprising a multi-colored lamp which may be used with the holders orguide of FIGS. 3, 6, and 9;

FIG. 11D is an enlarged fragmentary view of region 11 of FIGS. 3, 6, and9 provided to illustrate a further alternative indicator embodimentcomprising a tri-lamp indicator which may be used with the holders orguide of FIGS. 3, 6, and 9;

FIG. 12A is a schematic illustration of an exemplary system including adocking station and computer external to the docking station;

FIG. 12B is a schematic illustration of a further exemplary systemincluding a docking station and computer internal to the dockingstation;

FIG. 13 is a perspective view of a storage cabinet including fourrepresentative holders temporarily stored therein;

FIG. 14 is an exemplary log-on screen display;

FIG. 15 is an exemplary screen display for loading of a holder;

FIG. 16 is an exemplary screen display for verification of the itemsloaded in the holder;

FIG. 17 is an exemplary screen display for verification of the itemsloaded in the holder including a reference image of a medicament;

FIG. 18 is a perspective view of an exemplary automated medicamentdispensing machine with which the representative holders of FIGS. 1-10may be utilized;

FIG. 19 is a perspective view of the exemplary automated medicamentdispensing machine of FIG. 18, but with one exemplary exception storageapparatus in an outwardly-extended position ready to receivemedicaments;

FIG. 19A is an enlarged fragmentary view of a portion of the exemplaryexception storage apparatus of FIG. 19;

FIG. 20 is a perspective view of the exemplary automated medicamentdispensing machine of FIGS. 18 and 19 but with the representative holderof FIGS. 1-10 positioned on the exemplary exception storage apparatus;

FIGS. 21A-21C are schematic side sectional views of the representativeholder of FIGS. 1-5 and exception storage apparatus of FIGS. 19-20 takenalong section 21-21 of FIG. 20. FIGS. 21A-21C show an exemplary sequencefor loading the contents of the holder into the exception tray;

FIG. 22 is an exemplary series of medicament-containing pouch packagesof the type produced by the automated dispensing machine of FIGS. 18-20;

FIG. 23 is a perspective view of a further embodiment of a medicamentmanagement system including a docking station, holder, and sensor guide;

FIG. 24 is a perspective view of the medicament management system ofFIG. 23, but with the sensor guide in a storage position;

FIG. 25 is a partially exploded view of the medicament management systemof FIG. 23 including a docking station, holder, and sensor guide;

FIG. 26 is a top view of the medicament management system of FIG. 23including a docking station, holder, and sensor guide;

FIG. 27 is a left side elevation view of the medicament managementsystem of FIG. 23 including a docking station, holder, and sensor guide;

FIG. 28 is a section view of the medicament management system of FIG. 23taken along section 28-28 of FIG. 26;

FIG. 28A is an enlarged section view of the medicament management systemof FIG. 23 taken along section 28A-28A of FIG. 28;

FIG. 29 is a perspective view of an exemplary holder;

FIG. 30 is a top plan view of the exemplary holder of FIG. 29;

FIG. 31 is a bottom plan view of the exemplary holder of FIG. 29;

FIG. 32 is a perspective view of an exemplary sensor guide of FIG. 23;

FIG. 33 is a bottom plan view of the exemplary sensor guide of FIG. 23;

FIG. 34 is a partially exploded view of the sensor guide of FIG. 23;

FIG. 35 is an enlarged perspective view of a portion of FIG. 23including a sensor module;

FIG. 36 is an exploded view of an exemplary sensor module of the sensorguide of FIG. 23;

FIG. 37 is a perspective view of a further embodiment of a medicamentmanagement system including a docking station, holder, and sensor guide;

FIG. 38 is a perspective view of the medicament management system ofFIG. 37, but with the sensor guide in a storage position;

FIG. 39 is a partially exploded view of the medicament management systemof FIG. 37 including a docking station, holder, and sensor guide;

FIG. 40 is a top view of the medicament management system of FIG. 37including a docking station, holder, and sensor guide;

FIG. 41 is a left side elevation view of the medicament managementsystem of FIG. 37 including a docking station, holder, and sensor guide;

FIG. 42 is a section view of the medicament management system of FIG. 37taken along section 42-42 of FIG. 37;

FIG. 42A is an enlarged section view of the medicament management systemof FIG. 37 taken along section 42A-42A of FIG. 42;

FIG. 43 is a section view taken along section 43-43 of FIG. 37illustrating exemplary interlock switches;

FIGS. 43A and 43B are enlarged section views of the exemplary interlockswitches of FIG. 43 taken along sections 43A-43A and 43B-43B of FIG. 43;

FIGS. 44A-44B are perspective and top plan views of the docking stationof FIG. 37;

FIG. 45 is a perspective view of the exemplary holder of FIG. 37;

FIG. 46 is a side elevation view of the exemplary holder of FIG. 45;

FIG. 47 is a top plan view of the exemplary holder of FIG. 45;

FIG. 48 is a perspective view of the exemplary sensor guide of FIG. 37;

FIGS. 49A and 49B are top and bottom plan views of the exemplary sensorguide of FIG. 37;

FIG. 50 is a partially exploded view of the sensor guide of FIG. 37;

FIG. 51 is an enlarged perspective view of a portion of FIG. 50including a sensor module;

FIG. 52 is an exploded view of an exemplary sensor module of the sensorguide of FIG. 23;

FIG. 53 is a schematic block diagram of exemplary systems for itemmanagement;

FIG. 54 is an exemplary screen display for loading a holder for thesystem of FIG. 23;

FIG. 55 is an exemplary screen display for selection of an availableholder;

FIG. 56 is an exemplary screen display for selection of a medicamentcontainer;

FIG. 57 is an exemplary screen display for holder filling;

FIG. 58 is an exemplary screen display for completion of holder filling;

FIG. 59 is an exemplary screen display for prescription ordercompletion;

FIGS. 60-63 are exemplary screen displays for an overcount error;

FIG. 64 is an exemplary screen display for an undercount error;

FIGS. 65-66 are exemplary screen displays for a medicament placementerror;

FIGS. 67-72 are exemplary screen displays for a verification process;

FIG. 73 is an exemplary screen display for loading a holder for thesystem of FIG. 37;

FIG. 74 is an exemplary screen display for selection of an availableholder;

FIG. 75 is an exemplary screen display for selection of a medicamentcontainer;

FIG. 76 is an exemplary screen display for holder filling;

FIG. 77 is an exemplary screen display for completion of holder filling;

FIG. 78 is an exemplary screen display for prescription ordercompletion;

FIGS. 79-82 are exemplary screen displays for an overcount error;

FIG. 83 is an exemplary screen display for an undercount error;

FIGS. 84-85 are exemplary screen displays for a medicament placementerror; and

FIGS. 86-91 are exemplary screen displays for a verification process.

While the systems, apparatus, and methods are susceptible to variousmodifications and alternative forms, specific embodiments thereof havebeen shown by way of example in the drawings and are herein described indetail. It should be understood, however, that the description herein ofspecific embodiments and methods is not intended to limit the inventionto the particular forms disclosed, but on the contrary, the intention isto cover all modifications, equivalents, and alternatives falling withinthe spirit and scope of the invention as defined by the appended claims.

DETAILED DESCRIPTION

Referring first to FIGS. 1-9 and 12A, there are shown embodiments of anexemplary system 10 for management of items. The embodiments aredescribed in the context of a preferred item-management system formanagement of medicament 11 items. System 10, preferably includes holder13, docking station 15 to which holder 10 may be temporarily docked, andcontroller 17 which may include one or more controls capable ofoperating system 10. The term “at least one controller,” therefore,means or refers to embodiments in which controller 17 includes one ormore controller components. Controller 17 may include componentsinternal and/or external to docking station 15. In a further exemplarysystem 10′ (FIG. 12B), controller 17 is illustrated as being entirelywithin docking station 15. System 10 may be configured and arrangedbased on the needs of the pharmacy, hospital, long-term care facility orother operator. While it is envisioned that embodiments of system 10 or10′ will be utilized in the health-care industry, it should beunderstood that such systems and others may have application in fieldsoutside of the health-care industry for dispensing of items other thanmedicaments 11.

Referring then to FIGS. 1-5, there is shown an exemplary holder 13 formanaging and organizing medicaments. A further exemplary holder 13′ isillustrated in FIG. 6. The word “holder” means or refers to apparatuswhich holds one or more items. Holder 13′ is a wireless-type holder butis otherwise identical to holder 13. For simplicity and brevity, likereference numbers of holder 13 and docking station 15 are used toidentify like parts of holder 13′ and docking station 15′ and thedescription of holder 13 and docking station 15 are incorporated byreference with respect to holder 13′ and docking station 15′.

Exemplary holder 13, 13′ has a tray-like appearance in that holder 13,13′ is a flat, shallow container used for carrying, holding, andorganizing items which are preferably medicaments 11. However, otherholder configurations may be utilized depending on the needs of theuser.

For simplicity and brevity, like reference numbers of holder 13 anddocking station 15 are used to identify like parts of holder 13′ anddocking station 15′ and the description of holder 13 and docking station15 are incorporated by reference with respect to holder 13′ and dockingstation 15′.

Exemplary holder 13, 13′ includes a body 19, a top and a bottom 21, 23,a front and a rear side 25, 27, and a left and a right side 29, 31.Holder 13, 13′ further includes cells, of which cell 33 isrepresentative. Each cell 33 is defined by a wall 35, of which wall 35is representative. For purposes of simplicity and brevity, each cell 33of holder 13, 13′ is indicated by reference number 33 and each wall isindicated by reference number 35.

Each wall 35 defines a cell 33 upper opening, or inlet 37, and a celllower opening, or outlet 39. As shown in the examples, the cell inlets37 extend through, and are included in and along, the body top 21 whilethe cell outlets 39 extend through, and are included in and along, thebody bottom 23. In the embodiments, medicaments 11 are loaded into eachcell 33 through inlet 37 and are discharged from cell 33 through outlet39 as described in detail below.

In the embodiments, each cell 33 is identical and, as noted, referencenumber 33 indicates each identical cell 33. However, it is possible thatcells 33 of holder 13, 13′ may have a structure which is not identicaland which may differ depending on the needs of the user.

Referring to FIGS. 1-6 each exemplary holder 13, 13′ shown includessixty four total cells 33 organized into four rows of sixteen cells. Inthe examples, the organization of cells 33 is identical to theorganization of cells 41 of exception storage apparatus 43 shown pulledout from automated dispensing machine 45 in FIGS. 18-21C. Exemplaryholder 13, 13′ is configured and arranged such that each cell 33 outlet39 is in registry with (i.e., aligned with) a corresponding cell 41 ofexception storage apparatus 43 permitting direct movement of medicaments11 from holder 13, 13′ into exception storage apparatus 43 as shown inthe example of FIGS. 21A-21C. Holder top 21 is preferably provided withhuman-readable indicia 47 identifying each cell 33. In the examples,indicia 47 is an integer from 1 to 64 proximate each cell 33. Othertypes of indicia 47 may be used, such as alpha-numeric indicia.

Holder 13, 13′ further includes at least one indicator 49 for each cell33, of which indicator 49 is representative. For purposes of simplicityand brevity, each indicator of holder 13, 13′ is indicated by referencenumber 49. An indicator 49 is located on holder 13, 13′ top side 21 nextto each cell 33. Each indicator 49 could be located inside body 19 ifbody is translucent. One indicator 49 is provided for each cell 33 for atotal of sixty four indicators 49 in these examples. Each indicator 49may be a visible indicator in the form of a selectively-operable lamp(i.e., an artificial light source). Energizing of each lamp-typeindicator 49 indicates the cell 33 into which the medicament 11 or otheritem is to be loaded. Preferably, each indicator 49 is a light-emittingdiode (LED), although it is envisioned that other types of lamp-typeindicators 49 may be used.

Controller 17 is operable to selectively operate each indicator 49 whenholder 13 is docked at docking station 15. Selective operation of anindicator 49 proximate to a cell 33 prompts the technician or pharmacistto place each medicament 11 into the cell 33 associated with theactivated indicator 49 or indicators 49. Collectively, the indicators 49comprise a type of pick-to-light system. Thus, if a medicament 11 is tobe loaded in the cells 33 designated by human-readable indicia 47 ascells 1, 3, 6, 9, 12, 15, 18, 21, 24, and 27, each of the indicators 49next to such cells 33 may be activated communicating to the technicianor pharmacist the specific cells 33 which should contain that medicament11. Use of a pick-to-light system of indicators 49 advantageouslycommunicates information to the technician or pharmacist without resortto a set of written instructions. A pick-to-light system is far superiorto written instructions because the person responsible for loading orverification of holder 13, 13′ need not take his or her eyes off ofholder 13, 13′ to read the instructions thereby increasing accuracy andreducing the time required to load or verify the medicaments 11 thatshould be in the holder 13, 13′.

As illustrated in yet a further embodiment illustrated in FIGS. 11A,11B, and 11C, indicator 49 could comprise a single multi-coloredindicator 49 for each cell 33. For example a multi-colored LED lampcould be used as indicator 49. As is known, changing the voltage to amulti-colored LED or selectively activating one of plural LED anodescauses the LED to emit a different color as represented in FIGS.11A-11C. Each different color can be used to communicate a differenttype of information to the technician loading the holder 13, 13′. Forexample, a red color signal from indicator 49 (FIG. 11A) could indicatethat one medicament 11 is to be loaded into that cell 33. A green-colorsignal from indicator 49 (FIG. 11B) could indicate that more than onemedicament 11 is to be loaded in that cell 33. A yellow-color signalfrom indicator 49 (FIG. 11C) could indicate that a half-size medicamentis to be loaded in that cell 33.

A further indicator 49 embodiment is illustrated in FIG. 11D. In theexample of FIG. 11D, a plural-lamp indicator 49 could be provided foreach cell 33 for purposes of communicating information to the technicianor pharmacist. In FIG. 11D, a plural-lamp indicator 49 consisting ofthree lamps is provided adjacent each cell 33. Any number of lamps couldbe used. Each lamp of indicator 49 could, for example, consist of an LEDlamp of a different color, such as red 49 a, green 49 b, or yellow 49 c.Each color could indicate a different type of information as describedin connection with the multi-colored LED example of FIGS. 11A-11C.Energizing of only the red-color indicator 49 a could indicate that onemedicament 11 is to be loaded into that cell 33. Energizing of only thegreen-color indicator 49 b could indicate that more than one medicament11 is to be loaded in that cell 33. Energizing of only the yellow-colorindicator 49 c could indicate that a half-size medicament is to beloaded in that cell 33. Alternatively, the lamps may all be of the samecolor and the number of activated indicator lamps 49 proximate each cell33 could indicate the quantity of medicaments to be placed in each cell33. Alternatively, the indicator 49 could have a blink patternindicating the medicament 11 to be loaded into the cell 33. A constantblink could indicate that one medicament 11 is to be loaded into thecell, two blinks could indicate that more than one medicament 11 is tobe loaded in that cell 33, and three blinks could indicate that ahalf-size medicament is to be loaded in that cell 33. Operation of theindicators 49 as described can also be used for verification ofmedicaments received in each cell 33.

Holder 13, 13′ further includes a pair of legs 51, 53 depending fromholder 13, 13′ bottom side 23. Legs 51, 53 may be provided to supportholder 13 on a surface (such as counter top 85). Referring to FIGS. 1and 5, bottom side 23 may extend outwardly from holder sides 29, 31 fora purpose described below.

Referring to FIGS. 1-6 and 21A-21C, exemplary holder 13, 13′ furtherincludes a planar shuttle member 55 positioned in planar track 57 inholder proximate each cell 33 outlet 39. Shuttle member 55 includesopenings 59 and a pull 61 which permits the technician or pharmacist tograsp shuttle member 55 with his or her hand and to pull or push shuttlemember 55.

In the example, shuttle member 55 is movable between a first position inwhich shuttle member 55 covers and closes each cell 33 outlet 39 asshown in FIG. 21A and a further position in which the shuttle member 55openings 59 are in alignment with each cell 33 outlet 39, therebyopening each cell outlet 39 permitting medicaments 11 to drop from eachcell 33 into a corresponding cell of exception storage apparatus 43 asshown in FIG. 21C. The first position of shuttle member 55 is referredto herein as a “cell-closed position” and the further position ofshuttle member 55 is referred to herein as a “cell-opened position.” Inbetween these positions, the cells 33 are partially open permittingmedicaments to start to fall from cells 33 as shown in FIG. 21B.

In the embodiments, shuttle member 55 serves as a gate, opening andclosing each cell 33 as shuttle member 55 moves between the cell-closed(FIG. 21A) and cell-opened positions (FIG. 21C). Shuttle member 55thereby blocks each cell outlet 39 in the cell-closed positionpermitting a medicament 11 to be loaded into each cell 33 for organizingand storage and further opens each cell outlet 39 permitting eachmedicament 11 to be discharged from holder 13, 13′ for loading intoexception storage apparatus 43 as described below.

Referring to FIG. 3, holder 13 and docking station 15 may includestructure configured to enable or facilitate docking of holder 13 withdocking station 15. In the embodiment, holder 13 is provided with afemale alignment pin receiver 63 and docking station 15 is provided witha male alignment pin 65 which is inserted into and seated in receiver 63when holder 13 is docked with docking station 15. The mechanicalinterconnection of receiver 63 and pin 65 properly locates holder 13 atdocking station 15. A contact-switch-type proximity detector 66 may beprovided to indicate to controller 17 that holder 13 is properly dockedat docking station 15. Holder 13′ and docking station 15′ may beprovided with receiver 63, pin 65, and detector 66.

FIGS. 1-5 and FIG. 6 are provided to show exemplary types of connectionsbetween a holder and a docking station. Referring first to FIGS. 1-5, anexemplary electro-mechanical connection between holder 13 and dockingstation 15 is shown. In the example, holder 13 body 19 is provided witha pair of electrical contacts 67, 69 permitting control over operationof indicators 49 through docking station 15 and controller 17. Twocontacts 67, 69 are not required as any number of contacts will suffice.When holder 13 is properly docked with docking station 15, contacts 67,69 are brought into operable connection with corresponding contacts 71,73 on docking station. Contacts 71, 73 are connected by suitableelectrical conductors 75, 77 to programmable logic controller 79 ofcontroller 17. Contacts 67, 69 are operably connected to indicators 49through appropriate conductors (not shown) permitting selectiveenergizing and operation of indicators 49 to indicate the cell 33 intowhich each medicament 11 is to be loaded. Examples of representativecontacts 67, 69, 71, 73 for a holder 13 with sixty four indicators 49are Amplimite™ 37 position, size 4 HD-20 male and female contactsavailable from Tyco Electronics of Harrisburg, Pa.

Referring now to FIG. 6, the holder 13′ embodiment shown thereinincludes structure enabling wireless connection between holder 13′,docking station 15,' and controller 17. Holder 13′ includes a controlcircuit board 68, with a wireless transmitter/receiver 70 powered by abattery 72 associated with holder 13′. Board 68 is operably connected toindicators 49 through appropriate conductors (not shown) permittingselective energizing and operation of indicators 49 to indicate the cell33 into which each medicament 11 is to be loaded or to permitverification of medicaments 11 received in cells 33.Transmitter/receiver 70 sends and receives signals with docking station15′ transmitter/receiver 74 permitting selective operation of indicators49 through docking station 15′ and controller 17.

In the examples of FIGS. 1-5 and FIG. 6, exemplary holder 13, 13′ anddocking station 15, 15′ are provided with apparatus 81, 83 for uniquelyidentifying holder 13, 13′ to docking station 15, 15′ and system 10 or10′ as shown schematically in FIG. 3. Positive identification of holder13, 13′ enables the user to precisely control loading of appropriatemedicaments 11 into holder 13 and 13′ permits the user to maintain moreaccurate records of medicaments 11 which have been dispensed. In suchembodiments, holder 13, 13′ may include an identification element 81 anddocking station 15, 15′ may include an identification element detector83 as shown in FIG. 3. The identifier element 81 may, for example,consist of a radio frequency identification tag (RFID) and the detector83 may be an RFID tag reader (i.e., an interrogator) on docking station15. The exemplary RFID tag 81 may be re-writable or read-only, asdesired. Exemplary RFID reader 83 provided on docking station 15, 15′detects information embedded on the RFID tag 81. Information embedded inRFID tag 81 identifying holder 13, 13′ may be used by system 10, 10′ tocontrol the medicament-dispensing process.

An identification element detector 84 may be provided on automateddispensing machine 45 (FIGS. 19, 20). In the example utilizing RFIDtags, detector 84 may comprise an RFID reader. If the correct holder 13,13′ identification element 81 is detected by detector 84, the technicianor pharmacist is prompted to transfer medicaments 11 from holder 13, 13′to exception storage apparatus 43. Conversely, if an incorrect holderidentification element 81 is detected by detector 84, the technician orpharmacist is prompted to not load the exception storage apparatus 43.Holder 13, 13′ may be made of any suitable material or combination ofmaterials. Preferably, body 19 is made of plastic material constructionfor reasons of ease of manufacture, low weight, ease of cleaning, andcost. Indicators 49 are preferably LED-type lamps but may comprise othertypes of visible indicators.

Referring next to FIG. 1-3, and FIG. 6 there are shown embodiments ofdocking stations 15, 15′ capable of use with a respective exemplaryholder 13, 13′. Each docking station 15, 15′ may be placed on a countertop 85, such as the counter top 85 at a workstation in a pharmacy,long-term care facility, hospital, or other facility. A mounting bracket87 may be provided to mechanically secure docking station 15, 15′ tocounter top 85.

Each exemplary docking station 15, 15′ preferably includes housing 89including top and bottom walls 91, 93, left and right side walls 95, 97and front and rear walls 99, 101. Indicator 102 is provided on frontwall 99. Indicator 102 is preferably an LED lamp which is activated if aholder 13 is properly docked at docking station 15, 15′ and isrecognized as an authorized holder 13 by system 10, 10′ by means ofidentifier element 81.

In the embodiments of FIGS. 1-3 and FIG. 6, housing 89 encloses aprogrammable logic controller (PLC) 79 and a power supply 103. In suchembodiments, PLC 79 is a component of controller 17. Power-supply port105 is provided for connection to a suitable 120 Volt electrical powersource by means of an electrical cord (not shown) to supply electricalpower to PLC 79. PLC 79 includes instructions permitting selectiveclosing and opening of relays within PLC 79 corresponding to theindicator(s) 49 of holder 13, 13′ which are to be selectively operatedto indicate the cell 33 into which each medicament 11 is to be placed.Power supply 103 preferably provides 5 Volt DC power to selected ones ofLED-type indicators 49 once the appropriate relays of PLC 79 areselectively closed, thereby providing selective energizing and operationof indicators 49. In embodiments utilizing a multi-color LED-typeindicator 49 (FIGS. 11A-11C) PLC 79 may also regulate the voltage toeach indicator 49 or selectively energize the anodes to change the coloremitted by the multi-colored LED. In wireless holder embodiments 13′,control circuit board 68 (e.g., a controller on board 68) activatesindicator 49 responsive to signals generated by PLC 79 totransmitter/receiver 74. An exemplary PLC 79 suitable for use as acomponent of controller 17 is a Model 06 Koyo Electronics PLC availablefrom Automation Direct, Inc. of Cumming, Ga.

Referring to the embodiment of FIG. 12A, system 10 may include a server107 operably connected to PLC 79 via data port 109 and communicationlink 111. In the embodiment, controller 17 includes both PLC 79 andserver 107 operatively connected thereto. Server 107 may include memory113 with a program of instructions 115 residing in memory 113. Server107 is representative of any data management system operated by apharmacy, hospital, long-term care facility, or other operator forpurposes of managing information related to dispensing of medicaments11. Communication link 111 may be any link capable of transmitting dataand other information. Link 111 may, for example, comprise a dedicatedland line, wireless link, ethernet, Internet, intranet, local areanetwork (LAN), or other suitable connection enabling data transmissionbetween PLC 79 and server 107. Server 107 is preferably an off-the-shelfcomputer representative of any suitable data-management controller. Itis envisioned that holder 13 can be connected directly to server 107without a docking station 15, for example through a suitablecommunication link.

In a further illustrative embodiment represented by FIG. 12B, system 10′includes an on-board computer 117 within docking station 15, 15′ housing89 and computer 117 serves as controller 17. Computer 117 includes aprogram of instructions 119 residing in memory 121 which are operable toselectively energize and operate the indicators 49 to indicate the cell33 into which one or more medicament(s) is/are to be placed. In thisembodiment, computer 117 is linked to automated dispensing machine 45via communication link 123 and server 124. Communication link 123 may beof the type as described previously in connection with link 111 andserver may be a pharmacy information system server provided to managepharmacy workflow generally. Overall activation of indicators 49 isprovided by computer 117 in this example. System 10′ is otherwiseidentical to system 10 and the description of system 10 is incorporatedby reference with respect to system 10′.

Each docking station 15, 15′ further preferably includes a video display125, keyboard 127, and mouse 129 permitting a technician or pharmacistto input and receive information from server 107 or computer 117 ofcontroller 17. A biometric identification device 130 may be provided topermit the technician or pharmacist to be identified to the system 10 or10′, particularly when logging on to the system. The biometric device130 may be a fingerprint reader, retina scanner, or other suitabledevice. A bar code scanner 131 is preferably operably connected tocontroller 17. Video display 125 is preferably a touch screen displaypermitting a technician to input information to controller 17 by simplytouching her finger on a desired portion of the display 125. Bar codescanner 131 may be any off-the-shelf scanner capable of reading a barcode 133 on a container 135 provided to hold medicaments 11. Keyboard127 may be an off-the-shelf QWERTY-type keyboard 127 permitting atechnician to input information to controller 17 and system 10, 10′.

FIGS. 7, 8, 9, and 10 illustrate a further holder 13″ and dockingstation 15″ embodiment suitable for use with an item-management system,such as system 10 or 10′. For simplicity and brevity, like referencenumbers of holders 13, 13′ and docking stations 15, 15′ are used toidentify like parts of holder 13″ and docking station 15″ and thedescription of holders 13, 13′ and docking stations 15, 15′ areincorporated by reference with respect to holder 13″ and docking station15″. The embodiment of FIGS. 7-10 differs from the embodiments of FIGS.1-6 because the indicator or indicators 49 which areselectively-operable to indicate the holder cell 33 into which an itemis to be loaded are located on a guide 136 associated with dockingstation 15″. Use of guide 136 with indicators 49 located thereon enablesuse of the item-management system with a holder 13″ which does notinclude indicators 49 thereon, typical of holders presently in use.

Referring further to FIGS. 7-10, holder 13″ includes body 19, top andbottom sides 21, 23, sides 25-31, cells 33 (including inlet and outletopenings 37, 39), legs 51, 53, shuttle member 55. An identificationelement 81 of the type previously described is preferably provided onbody 19. An alignment pin receiver 63 may be provided to receive pin 65of docking station 15″ to position holder 13″ at docking station 15″.Exemplary docking station 15″ includes detector 83, housing 89 withwalls 91-101, lamp 102, power supply 103, and ports 105, 109, and isprovided with a video display 125, keyboard 127, mouse 129, biometricidentification device 130, and bar code scanner 131 for the purposesdescribed in connection with docking stations 15, 15′.

Docking station 15″ includes a guide 136 attached to housing front wall99. Guide 136 is preferably a planar member located in a plane above aholder 13″ docked at docking station 15″ beneath guide 136. Guide 136 isprovided with openings, each of which is identified by reference number138 for brevity. In the example, guide 136 is provided with 64 totalopenings 138 grouped in four rows of openings 138. This opening 138pattern is identical to the pattern of cells 33 in holder 13″. Thisopening 138 pattern is such that the openings 138 in guide 136 are inregistry and alignment with the corresponding cells 33 of holder 13″when holder 13″ is docked at docking station 15″. This arrangementallows a technician to rapidly and accurately load each cell 33 ofholder 13″ by inserting a medicament through the appropriate opening 138in guide and into the corresponding cell 33 during holder 13″ loading.

Indicators 49 on guide 136 are proximate each opening 138 to indicate tothe technician, upon activation, which opening 138 a medicament 11 orother item is to be inserted. Indicators 49 may, for example, be asingle lamp (preferably an LED) as illustrated in FIGS. 1, 3-4, 6-7, and9, a multi-colored LED as illustrated in FIGS. 11A-11C, or pluralindicators 49 as illustrated in FIG. 11D, or another indicator type.Human-readable indicia 140 is preferably provided on guide 136 so thateach opening 138 on guide 136 has the same indicia 140 as indicia 47,211 on holder 13″ and exception storage apparatus 43. Indicia 140further assists the technician to ensure that the correct medicament 11is loaded into the correct guide 136 opening 138. Guide 136 indicators49 are connected to PLC 79 through appropriate conductors (not shown)permitting selective energizing and operation of indicators 49 toindicate the opening 138 through which each medicament 11 is to beloaded. Guide 136 may be made of any suitable material such as metal,plastic, laminate or a combination of materials.

Docking station 15″ is otherwise identical to docking station 15previously described and illustrated and the description of dockingstation 15 is incorporated by reference. Controller 17, as previouslydescribed, controls operation of docking station 15″ and indicators 49on guide 136 and holder 13″, docking station 15″, and controller 17 maybe used as part of an item-management system, such as system 10 or 10′(FIGS. 12A, 12B).

FIGS. 14-17 are exemplary screen displays of a type which could bedisplayed to a technician or pharmacist on display 125 for purposes ofimplementing system 10 or 10′ using holder 13, 13′, or 13″ and dockingstation 15, 15′, or 15″. The screen displays of FIGS. 14-17 are intendedto represent non-limiting examples as the type and number of screendisplays can be modified and the information provided in the screendisplays may be customized to meet the needs of the particular pharmacy,hospital, long-term care facility or other operator. For convenience andbrevity, the screen displays of FIGS. 14-17 are described in connectionwith system 10 including holder 13 and docking station 15, it beingunderstood that the screen displays and methods of implementing system10 are applicable for use with system 10′ or with holder 13′, 13″ anddocking station 15′, 15″.

Referring to the screen displays of FIGS. 14-17, a technician orregistered pharmacist initiates use of system 10 by logging on to thesystem 10, preferably at docking station 15. Preferably, loading ofholder 13 is performed by a technician while verification of the loadedholder 13 is performed by a registered pharmacist.

Referring to FIG. 14, the technician is initially presented with alog-on screen 137 displayed on video display 125. The technician logs onto the system 10 by keying his or her password into the password field139 using keyboard 127 and selecting the ENTER icon 141. Alternatively,the technician could utilize biometric device 130 to identify herself tothe system 10. The technician's password information is transmitted toserver 107 (or server 124 in system 10′), whereupon it is determinedthat the technician is an authorized user.

If a holder 13 is not already docked at docking station 15 as shown inFIGS. 1-3 (or is not in wireless communication with docking station 15′as in FIG. 6), a further screen (not shown) may be displayed on videodisplay 125 prompting the technician to dock a holder 13 at dockingstation 15. In the example of FIGS. 1-3, holder 13 is shown docked atdocking station 15 by insertion of pin 65 in receiver 63, therebypositioning holder 13 to form an electrical connection between holdercontacts 67, 69 and docking station contacts 71, 73. Identificationelement detector 83 identifies the unique identifier element embedded inholder 13. Detector 83 preferably detects an RFID-type identificationelement 81 to identify holder 13 to system. If the docked holder 13 isrecognized by system 10 (or if wireless-type holder 13′ is recognized bysystem 10), indicator lamp 102 is activated to inform the technicianthat the system 10 is in a ready state. Proximity detector 66 may alsoindicate to controller 17 that holder 13 is properly docked at dockingstation 15.

Referring next to FIG. 15, if the technician is authorized and if holder13 is docked and recognized, then a holder-loading screen 143 isdisplayed on video display 125. Holder-loading screen 143 providesinformation for loading each medicament 11 into the correct cell 33.

Information which may be presented on holder-loading screen 143 caninclude an identification field 145 identifying the operator name (e.g.,Nowtime Pharmacy), technician name, and date and time-of-day on whichholder 13 is being loaded. Additional information which may be displayedin connection with screen 143 is the holder identifier 147 andtransaction code 149 which indicates the transaction corresponding toloading of the holder 13 for record-keeping purposes. Preferably, thetransaction number and all other information relating to loading andverification of holder 13 is stored in a database on server 107 or 124.Holder identifier 147 may be any symbol or group of symbols capable ofdistinguishing one holder 13 from another holder 13. In the example,holder identifier 137 is identical to the identifier embedded in RFIDtag-type identification element 81. In the example, the holderidentifier 147 is the number 2. A unique identifier 147 can be importantif more than one identical holder 13 is used by the pharmacy, hospital,long-term care provider or other operator.

Referring further to FIG. 15, holder-loading screen 143 includesinformation 151 required for loading of cells 33 of holder 13.Preferably, information 151 is displayed in the form of a graphical userinterface (GUI), thereby facilitating ease of use by the technician. Inthe example, information 151 includes a select field 152, a celllocation field 153, a medication type field 155, a dosage strength field157, an NDC number 159 field, a shelf location 161 field, and a status163 field. In the example, information 151 is displayed for eachmedicament 11 to be loaded into holder 13. In the example of FIG. 15,three medicament 11 types, namely, Cardura tablets, Azithromycintablets, and Coumadin tablets are to be loaded into holder 13.

The cell location field 153 identifies the cell 33 into which medicament11 is to be loaded by referencing the human-readable indicia 47associated with the designated cell 33. In the example, Cardura tabletsare to be loaded into cells of holder 13 associated with thehuman-readable indicia 47 represented by numbers “1, 3, 6, 9, 12, 15,18, 21, 24, 27” while the other medicaments are to be loaded into theother cells 33 of holder 13 identified in the cell location field 153.The ordering of the medicaments 11 is determined by the order in whichthe medicaments 11 are required in order to load each container orcontainers (e.g., a vial, bottle, blister package, or pouch package) foreach prescription order or dispense request. For example, server 107 mayorder the medicaments 11 presented on screen 143 based on the sequencein which prescription orders or dispense requests are to be filled formore than one patient or may order the medicaments 11 presented onscreen 143 based on a drug regimen for a single patient, for example,ordering the medicaments by the time of day the medicaments 11 are to betaken by the patient (e.g., breakfast, lunch, and dinner). The slowmover medicaments 11 indicated on screen 143 may be arranged and orderedfor serial dispensing (i.e., one-after-the-other) or may be arranged andordered to alternate with medicaments dispensed from other storageapparatus (e.g., cassettes, cells, canisters, etc.) within automateddispensing machine 45.

The medication type field 155 and dosage strength field 157 informationrefers to the type and strength of the medicament 11, while the NDCnumber field 159 information refers to the 10-digit National Drug Code(NDC) number for the specific medicament 11 called for by theprescription order or dispense request.

The shelf location field 161 information refers to the shelf location ofthe pharmacy, hospital, long-term care facility, or the like at whichthe medicament container, for example representative container 135 (FIG.1), holding a medicament 11 is located. This information is provided toassist the technician in retrieving the container 135 from storage. Inthe example, fictitious alpha-numeric shelf locations are displayed.

As illustrated in FIGS. 1 and 7, it is envisioned that the technicianwill scan the bar code 133 on the container 135 with bar code scanner131. Program of instructions 115 running on server 107 can then verifythat the correct container 135 has been selected from storage based oninformation contained in bar code 133. The technician can also verifythat the correct medicament container 135 has been selected by comparingthe medication type 155, strength 157, and human-readable NDCinformation 159 on the screen 143 with human-readable information on thelabel for container 135.

The status information field 163 indicates the status of theholder-loading process. Selection of each medicament 11 for loading canbe made simply by touching the technician's finger on the row 165 oftouch-screen video display 125 associated with one medicament 11 or byselecting the row 165 with another input device, such as keyboard 127and mouse 129. In the example of FIG. 15, the technician is in theprocess of loading Cardura tablets into cells 33. This is indicated bythe row 165 associated with Cardura tablets having been selected asindicated by the X character in the select field 152 and the IN-PROCESStext in status information field 163. The row 165 associated with theAzithromycin tablets indicates FILLED in the status information field163 indicating that loading of the Azithromycin tablets has beenpreviously completed. The row 165 associated with the Coumadin tabletshas not yet been selected as indicated by the UNFILLED indication infield 153.

PLC 79 (or computer 117 in system 10′) selectively activates theindicator 49 for each cell 33 into which the medicament 11 is to beloaded once the appropriate row 165 associated with the medicament isselected. This pick-to-light feature enables the technician to loadmedicaments 11 without any necessity for reliance on written loadinginstructions. Thus, in the example of FIG. 15, the indicator 49,preferably an LED lamp, associated with each of cells 33 indicated bythe human-readable indicia 47 “1, 3, 6, 9, 12, 15, 18, 21, 24, 27” isenergized to tell the technician to load a Cardura tablet into each ofthese cells 33. Each indicator 49 associated with each other cell 33 ofholder 13 is not activated. Activation of only each indicator 49associated with the cell to be loaded is referred to herein as selectiveindicator 49 activation or operation.

Once all cells 33 associated with a row 165 are filled, the technicianthen selects the next row 165 of medicaments to be filled and proceedsto load holder 13 as directed by indicators 49. Selection can again beaccomplished by touching the technician's finger on the row 165 oftouch-screen video display 125 associated with the next medicament 11 tobe loaded in holder 13 or by selecting the row 165 with the keyboard 127or mouse 129. The indicator or indicators 49 previously activated aredeactivated and the appropriate indicators 49 for the next medicament 11to be loaded are activated. This process is repeated until allmedicaments 11 have been loaded in holder 13 as called for by screen143.

Once all cells 33 of holder 13 are loaded as required by holder-loadingscreen 143, the technician clicks on, or otherwise selects, the HOLDERFILLED icon 167. Selection of icon 167 sends a signal to server 107 (orserver 124 in system 10′) indicating that loading of holder 13 has beencompleted. Each loaded holder 13 can subsequently be verified by aregistered pharmacist prior to loading of medicaments 11 from loadedholder 13 into automated dispensing machine 45.

Referring now to FIG. 13, a storage cabinet 169 may optionally beprovided to store one or more holder 13, 13 a, 13 b, and 13 c therebyfacilitating loading and verification of multiple holders. In theexample, each holder represented by reference numbers 13 a, 13 b and 13c has structure identical to holder 13. Loaded holders 13, 13 a, 13 b,and 13 c may be stored in cabinet 169 after loading and beforeverification or may be stored in cabinet 169 after verification by aregistered pharmacist and before loading of the verified medicaments 11into exception storage apparatus 43 of automated dispensing machine 45.

If provided, storage cabinet 169 includes top and bottom walls 171, 173,sidewalls 175, 177, and a front opening 179 through which holders (e.g.,holder 13) are placed into cabinet 169. Stacked opposed slot pairs181,183 may be provided to receive the bottom 23 of each holder 13permitting holders 13, 13 a, 13 b, and 13 c to be stored in cabinet 169.

As already noted, each loaded holder 13 can be verified by a registeredpharmacist to ensure that each cell 33 has been loaded with the correctmedicament 11. FIG. 16 shows an exemplary holder-verification screen 185which corresponds to the holder-loading screen 143 for that holder 13.Holder-verification screen 185 includes information 187 required forverification of the medicaments 11 loaded into cells 33 of holder 13.This information is essentially identical to that displayed inconnection with holder-loading screen 143. For convenience andsimplicity, reference numbers of information displayed on holder-loadingscreen 143 are used again to identify corresponding fields ofinformation on holder-verification screen 185.

As with the holder-loading screen 143, an identification field 145 canbe provided to identify the operator name (e.g., Nowtime pharmacy), nameof the pharmacist responsible for medicament 11 verification, and thedate and time-of-day on which holder 13 is verified. The holderidentifier 147 and transaction code 149 are also preferably displayedfor the same purpose as described in connection with the holder-loadingscreen 143.

Preferably, information 187 is again displayed in the form of agraphical user interface (GUI), thereby facilitating ease of use by theverifying pharmacist. In the example, the displayed information 187again includes a select field 152, a cell location field 153, amedication type field 155, a dosage strength field 157, an NDC numberfield 159, a shelf location field 161, and a status information field163 including the information described in connection withholder-loading screen 143. In the example, information 187 is againdisplayed for each medicament 11 to be loaded into holder 13. In theexample of FIG. 16, the Cardura tablets, Azithromycin tablets, andCoumadin tablets previously loaded into cells 33 of holder 13 arepresented for verification by the pharmacist.

In order to verify that each cell 33 holds the correct medicament 11,the pharmacist simply selects the row 165 to be verified. Selection isaccomplished by touching the touch screen display 125 on row 165 or byselecting row 165 with the keyboard 127 or mouse 129. The statusinformation field 163 again indicates the status of theholder-verification process.

Referring further to FIG. 16, the screen display 185 shows an example ofdisplayed information for verification that the Cardura tablets havebeen correctly loaded into the cells 33 indicated by the human-readableindicia 47 “1, 3, 6, 9, 12, 15, 18, 21, 24, 27” located on holder 13.Selection of the Cardura tablets for verification is indicated in theexample by the row 165 associated with Cardura tablets having beenselected as indicated by the X character in the select field 152 and theIN-PROCESS text in status information field 163. The row 165 associatedwith the Azithromycin tablets indicates VERIFIED in the statusinformation field 163 indicating that verification of the Azithromycintablets has been completed. The row 165 associated with the Coumadintablets has not yet been selected for verification as indicated by theUN-VERIFIED indication in field 163. A selected row 165 can also behighlighted to facilitate identification of the row 165 then beingverified.

Referring next to FIG. 17, a further verification screen display 186 maybe provided to assist the pharmacist with the verification process. Aseach row 165 is selected, a medicament-specific verification screen 186may be displayed. In the example, screen 186 displays the row 165 beingverified including the cell location field 153, medication type field155, dosage strength field 157, NDC number field 159, shelf locationfield 161, and status information field 163. Screen 186 also displays areference image of the physical appearance of the medicament 188together with a word description 190 of the physical appearance of themedicament 11. In this example of the Cardura medicaments 11, the worddescription 190 is white oblong tablet. A screen display similar todisplay 186 of FIG. 17, including a reference image 188 and worddescription 190, may be displayed to the technician during theholder-loading process associated with screen 143 to assist thetechnician in placing the correct medicament(s) 11 into each cell 33.

Upon selection of a row 165, PLC 79 of controller 17 again selectivelyactivates each indicator 49, preferably an LED lamp, for each cell 33 tobe verified by the pharmacist. As with the loading process, thispick-to-light capability enables the pharmacist to rapidly confirm thatthe correct medicament 11 has been loaded into the correct cell 33without the necessity for reliance on written verification instructions.The pharmacist can quickly compare the physical appearance of eachmedicament 11 in each indicated cell 33 without the necessity ofreliance solely on written instructions. This process is facilitated bypresentation of screen 186 and the reference image and descriptioninformation 188, 190 as the pharmacist can quickly compare theappearance of the medicament 11 on screen 186 with the appearance of themedicament(s) 11 in each cell 33 associated with an activated indicator49.

Thus, in the verification example of FIGS. 16-17, each indicator 49associated with each of cells indicated by the human-readable indicia 47“1, 3, 6, 9, 12, 15, 18, 21, 24, 27” into which Cardura tablets was tobe loaded, is activated by PLC 79 of controller 17 (or computer 117 insystem 10′) during the verification process. Each other indicator 49 isinactive.

If screen 186 is provided, selection of the DONE icon 192 returns thepharmacist to screen 185 for selection of the next medicament 11 to beverified.

Once all cells 33 associated with a row 165 are verified, the technicianthen selects the next row 165 of medicaments to be verified and proceedsto verify the medicament(s) in each cell 33 as directed by indicators49. The indicator or indicators 49 previously activated are deactivatedand the appropriate indicators 49 for the next medicament 11 areactivated. This process is repeated until all medicaments 11 have beenverified as called for by screen 185.

Once all rows 165 and medicaments 11 are verified, the pharmacistselects the HOLDER VERIFIED icon 189. Selection of icon 189 sends asignal to server 107 of system 10 (or server 124 of system 10′)indicating to system 10 that holder 13 has been fully verified and thatthe medicament 11 contents are in the correct cells 33 ready for usewith automated dispensing machine 45. A record may be made of theverified medicament 11 contents of holder 13 cells 33 which may bestored in a database residing on server 107 (or server 124). Such arecord is useful in further confirming that the correct medicaments 11were loaded in holder 13. Each verified holder 13 can then be stored incabinet 169 awaiting use, or the holder 13 and its medicament 11contents can be taken directly to automated dispensing machine 45 forimmediate loading of medicaments 11 into exception storage apparatus 43.

Referring now to FIGS. 18-20, there is shown an exemplary automateddispensing machine 45 and exception storage apparatus 43 which may bequickly and accurately loaded with medicaments 11 using holder 13 or 13′or 13″. Dispensing machine 45 includes a cabinet 191 with top and bottomwalls 193, 195 and left and right sidewalls 197, 199. A touch-screenvideo display 201 is mounted to sidewall 199. Display 201 includescontrols permitting a technician or pharmacist to control operation ofautomated dispensing machine 45 and to receive information about thestatus of the medicament filling process.

Exemplary automated dispensing machine 45 includes twenty pull-outdrawers of which drawers 203 are exemplary. In the example, drawers 203are organized into five rows of four drawers 203. Each drawer 203supports a plurality of removable cassette-type storage apparatus (notshown), each of which stores a large quantity of bulk-form medicaments11. The cassettes can be replenished as medicaments 11 stored thereinare depleted.

Exemplary automated dispensing machine 45 further includes a pair ofdoors 205, 207 which cover exception storage apparatus 43 as shown inFIG. 18 and which can be opened as shown in FIGS. 19-20. As previouslydescribed, exception storage apparatus 43 may be provided to store andto dispense “slow mover” medicaments 11 loaded therein. In the example,automated dispensing machine 45 includes a single exception storageapparatus 43. However, any number of exception storage apparatus 43 maybe provided based on the needs of the operator.

In the example, exception storage apparatus 43 is a drawer or tray-likedevice which can be pulled out from cabinet 191 as shown in FIGS. 19-20.When in the state of FIGS. 19-20, automated dispensing machine 45 istemporarily shut down and is out of service and unavailable to fillprescription orders and dispense requests while exception storageapparatus 43 is pulled out from cabinet 191. Therefore, it is importantto load exception storage apparatus 43 as promptly as possible to returnautomated dispensing machine 45 to service.

The exception storage apparatus 43 shown in FIGS. 19-20 can be describedas having a somewhat flat and narrow configuration with a plurality ofcells 41 provided therein. Each cell 41 of exception storage apparatus43 is capable of storing one medicament 11, or a small quantity ofmedicaments 11 as illustrated in FIGS. 21A-22. In the example, cells 41include 64 total cells grouped in four rows of 16 cells.

Cells 41 are indexed for movement along a track (not shown) in exceptionstorage apparatus 43. Cells 41 are indexed forward along the tracktoward an opening (not shown) in the bottom of apparatus 43 so that thecontents of each cell 41 fall through a cell bottom opening (not shown)and to a packaging device within automated dispensing machine 45 throughchutes, hoppers or other guide structure, or by a mechanical device suchas an auger. Medicaments 11 may be discharged from cells 41 by any othersuitable means including a movable gate (not shown) over a cell bottomoutlet (not shown), or by a solenoid, air-powered actuator, air-jet, ormechanical arm which ejects the medicament through an upper cell inlet209 of the type shown in FIG. 19A. The medicaments 11 fall via chutes,guides to a packaging device or are directed to packaging device bymechanical means (e.g. an auger).

In the example, automated dispensing machine 45 includes apouch-package-type packaging apparatus (not shown) within a lowerportion of cabinet 191. Alternatively, packaging apparatus capable ofpackaging medicaments 11 into other container types (e.g., bottles,vial, blister packages) may be utilized. A pouch-package-type packagingdevice includes a form-fill-seal packaging device. A “form-fill-seal”packaging device forms a package (i.e., a pouch) in a web of packagingmaterial, fills the package with the medicament(s), and seals thepackage forming a plurality of discrete packages, or pouches.

In the example, one or more medicament 11 discharged from thecassette-type storage apparatus (not shown) or exception storageapparatus 43 is loaded into separate pouches 202 formed (e.g., byheat-sealing or sonic welding) in a web of packaging material 204 asillustrated in FIG. 22. Information can be printed on each pouch 202 bya printer (not shown) associated with automated dispensing machine 45and such information can include the patient's name 206, medicament nameand quantity 208, prescription number 210, date 212, instructions fortaking the medicament 214 (such as time of day the medicament is to betaken) and machine-readable indicia 216 (such as a bar code)representative of the aforesaid information. Pouch packages are idealfor use in administering medication regimens because the exactmedicaments to be taken at a given time can be packaged together in asingle pouch, and the pouches can be organized and labeled in the exactorder in which each medicament is to be taken, for example, morning,noon and evening. An exemplary automated dispensing machine 45 is amodel ATP 320, 371, or 384 dispensing machine available from ChudyGroup, LLC of Powers Lake, Wis.

Transfer of medicaments 11 from holder cells 33 to exception storageapparatus 43 will now be described in connection with FIGS. 21A-21C. Inthe example, cells 33 of holder 13 are positioned and arranged so thatthey have a pattern which is identical to that of cells 41 in exceptionstorage apparatus 43. Holder 13, therefore, can be placed directly ontop of exception storage apparatus 43 as shown in FIG. 20 and FIGS.21A-21C with each cell 33 and 41 completely aligned and in registry. Inthe example, holder 13 and exception storage apparatus 43 each have 64total cells 33, 41 grouped in four rows of 16 cells. Human-readableindicia 211 is preferably provided on exception storage apparatus 43(FIG. 19A) so that each cell 33 on holder 13 has the same indicia 47 asindicia 211 on exception storage apparatus 43. The cell 33 pattern andindicia 47 of holder 13 is most preferably identical to the cell 41pattern and indicia 211 of exception storage apparatus 43.

Referring again to FIGS. 20 and 21A-21C, the verified holder 13 is takento exception storage apparatus 43 of automated dispensing machine 45 bya technician or pharmacist. Holder 13 is set on top of exception storageapparatus 43. Legs 51, 53 position holder 13 over exception storageapparatus 13 as shown, for example, in FIGS. 21A-21C to ensure thatholder 13 is in the correct orientation on exception storage apparatus43 with correct alignment of cells 33, 41. Once aligned, holder 13 isinitially in the position shown in FIG. 21A.

At this point in the process, identification element 81 is detected bydetector 84 of automated dispensing machine 45. If the correct holder 13is positioned over exception storage apparatus 43, thetechnician/pharmacist is given a prompt signal by video display 201. Ifan incorrect holder 13 is positioned over exception storage apparatus43, then display 201 prompts the technician/pharmacist to not transferthe medicaments 11 and may present an error message and/or alarm. Inaddition, system 10 or 10′ may deactivate automated dispensing machine45 preventing automated dispensing machine 45 operation until thecorrect holder 13 is in place or the technician/pharmacist overrides thesystem 10, 10′.

Prior to medicament 11 transfer and as shown in FIG. 21A, shuttle member55 is in its “closed” position with cell 33 outlets 39 covered byshuttle member 55. Medicaments 11 cannot exit cells 33 in this closedposition.

Next, and as shown in FIG. 21B, the technician grasps pull 61 and movesshuttle member 55 in the direction of arrow 217. Movement of shuttlemember 55 in the direction of arrow 217 partially opens cell outlets 39as openings 59 in shuttle member 55 are aligned with cell outlets 39. Asa result, medicaments 11 begin to fall by means of gravity into thealigned cells 41 of exception storage apparatus 43.

Finally, and as shown in FIG. 21C, the technician moves shuttle member55 fully in the direction of arrow 217 by means of pull 61 to fullyalign openings 59 in shuttle member 55 with cell outlets 39. Cells 33are fully open in this position causing medicaments 11 in cells 33 tofall into the corresponding cells 41 of exception storage apparatus 43.Exception storage apparatus is now correctly loaded and is ready fordispensing and packaging of the slow mover medicaments 11 stored incells 41. This loading process shown in FIGS. 21A-21C is very rapid(less than one minute) and enables automated dispensing machine 45 to bequickly returned to service.

Systems 10, 10′ accurately and rapidly enable loading of medicaments 11in the exact order in which the medicaments 11 are to be loaded intoexception storage apparatus 43. The medicaments 11 are rapidly verifiedby the system 10, 10′ and docking station 15 in a way which is notpossible based solely in reliance on written instructions. This isbecause selective operation of the indicators 49 permits pharmacypersonnel to load and verify the contents of holder 13 without having totake his or her eyes off of the holder 13 to read instructions. Eachexemplary system 10, 10′ therefore, speeds the holder-loading processwhile at the same time providing a high confidence level that each cell33 and 41 has been loaded with the correct medicament 11. Accurateloading of medicaments 11, in turn, provides a better level of care forall patients which, of course, is always the primary objective of anypharmacy, hospital, long-term care facility or other care-giver. And,time required for selecting, verifying, and loading medicaments 11 intothe automated dispensing machine is significantly decreased. This freespharmacists to better serve their patients and enables the automateddispensing machine 45 to be immediately returned to service. The resultonce again is improved patient care and reduced cost of operation to thepharmacy, hospital, long-term care provider or other operator.

Further Exemplary Embodiments

Referring now to FIGS. 23-53, there are illustrated further exemplaryitem-management systems 1010, 1010′. As with systems 10, 10′, systems1010, 1010′ are described in the context of a preferred item-managementsystem for management of medicament 1011 items.

A sensor guide 1301, 1301′ may be used with systems 1010, 1010′ toprovide heightened accuracy in loading holder 1013, 1013′. Sensor guide1301, 1301′ provides for medicament detection and for positive feedbackconfirming that the medicament 1011 or other item placed into holder1013, 1013′ was correctly placed into holder 1013, 1013′ providing anopportunity to reduce human-factors-related errors as described herein.

System 1010 illustrated in FIGS. 23-36 facilitates accurate and rapidloading of a holder 1013 in the form of a container used in loading anautomatic dispensing machine 49. System 1010′ illustrated in FIGS. 37-52facilitates accurate and rapid loading of a holder 1013′ in the form ofa container known as a blister package.

The terms “holder” and “container” are used interchangeably throughoutthis document. A “holder” or “container” means or refers to an apparatuswhich holds one or more items, such as medicaments 1011. Blisterpackages are a type of holder and container and are identified herein byreference number 1013′.

In the examples, each holder 1013, 1013′ is used in conjunction with arespective docking station 1015, 1015′ to which holder 1013 or holder1013′ may be temporarily docked. A controller 1017 may include one ormore control capable of operating systems 1010, 1010′. As with theabove-described embodiments, the term “at least one controller,”therefore, means or refers to embodiments in which controller 1017includes one or more controller components. Controller 1017 may includecomponents internal and/or external to docking station 1015, 1015′.

For simplicity and brevity, like reference numbers of system 1010 areused to identify like or similar parts of system 1010′.

In the example of system 1010, medicaments 1011 are loaded in holder1013 in the exact order in which medicaments 1011 are to be loaded intoexception storage apparatus 43 of automated dispensing machine 45,examples of which are described above. This may be the order in whichthe medicaments 1011 are to be taken by the patient. Once transferred toexception storage apparatus 43, automated dispensing machine 45 willpackage the medicaments 1011 into one or more pouch package 202 asdescribed in connection with systems 10, 10′ and as illustrated, forexample, in FIG. 22. Each pouch package 202 is subsequently delivered toa patient for whom the medicament 1011 is intended. If pouch packages202 are arranged in the order in which the medicaments 1011 are to betaken, the patient merely opens one pouch 202 after the other and takesthe medicament 1011 therein in accordance with the prescription orderprovided by the patient's physician.

In the example of system 1010′, the medicaments 1011 may also be loadedin an order required by a prescription order, for example in the orderin which the medicaments 1011 are to be taken by a patient in accordancewith the physician's instructions. Automated dispensing machine 45 isnot needed for system 1010′ because, after closure, holder 1013′ becomesthe container given to the patient. In embodiments, the patient canmerely push against a cell 1033 which then causes the medicament 1011 tobe pushed out of the holder 1013′ through a closure 1042 (e.g., a foilsafety seal) as described herein.

As with the previous embodiments, systems 1010, 1010′ utilize visibleinformation to assist pharmacy personnel (e.g., a technician, pharmacistor other user) in the loading and any verification of the contents ofholder 1013, 1013′ without having to take his or her eyes off of holder1013, 1013′ to read written instructions which may be written on a pieceof paper. For each of systems 1010, 1010′, the user simultaneously seesthe medicament 1011, the cell 1033, sensor guide opening 1317 andvisible information at the moment the medicament 1011 is hand loadedinto the cell 1033 which improves the accuracy of the prescriptionfulfillment and minimizes the risk of error.

Systems 1010, 1010′ make the tedious, labor-intensive, andtime-consuming process of loading holders 1013, 1013′ easier and faster,particularly if different types of medicaments 1011 must be loaded intoseparate cells 1033 of the same holder 1013, 1013′. Each exemplarysystem 1010, 1010′ therefore, provides an opportunity for better patientcare because there is an improved confidence level that the correctmedicament 1011 is being provided to the patient in accordance with thephysician's instructions and because time saved administeringmedicaments can be allocated to other aspects of patient care providedby the pharmacy, hospital, long-term care facility or other care-giver.

Systems 1010, 1010′ may be configured and arranged based on the needs ofthe pharmacy, hospital, long-term care facility or other operator. Whileit is envisioned that embodiments of systems 1010, 1010′ will beutilized in the health-care industry for loading of medicaments 1011, itshould be understood that such systems and others may have applicationin fields outside of the health-care industry for management anddispensing of items other than medicaments 1011. For example, smallparts could be loaded into a holder 1013 or a holder 1013′ of ablister-package-type 1013.

Referring next to FIGS. 28-31 and FIGS. 23-25, and 27, exemplary holder1013 of system 1010 will now be described. Exemplary holder 1013 may beused for loading an automatic dispensing machine 49 in the same manneras described previously in connection with systems 10, 10′ and holders13, 13′, 13″.

Holder 1013 illustrated in FIGS. 28-31 includes a body 1019, a top and abottom 1021, 1023, a front and a rear side 1025, 1027, and a left and aright side 1029, 1031. Holder 1013 includes cells 1033, each of which isdefined by a wall 1035. In the example of holder 1013, cells 1033 andwalls 1035 define an oval shaped cell 1033. The oval shape could matchan oval shape of cells 41 of exception storage apparatus 43. Forbrevity, only certain of the cells 1033 are indicated by referencenumbers 1033 and 1035, it being understood that each cell 1033 has thesame structure in the examples.

Holder 1013 has a tray-like appearance in that it is a flat, shallowcontainer used for carrying, holding, and organizing items which arepreferably medicaments 1011. As illustrated in FIGS. 28-31, holder 1013is a portable container which can be easily carried by a user fromdocking station 1015 to automatic dispensing machine 49 for transfer ofmedicaments 1011 from holder 1013 to exception storage apparatus 43.However, other configurations of holder 1013 may be utilized dependingon the needs of the user.

In the examples, each cell wall 1035 of holder 1013 defines a cell 1033upper opening, or inlet 1037, and a cell lower opening, or outlet 1039.As shown in the examples, the cell inlets 1037 extend through, and areincluded in and along, the body top 1021 while the cell outlets 1039extend through, and are included in and along, the body bottom 1023.Medicaments 1011 are loaded into each cell 1033 through inlet 1037 andare discharged from cell 1033 through outlet 1039.

In the examples, each cell 1033 is identical in structure. However, itis possible that cells 1033 of holder 1013 may have a structure which isnot identical and which may differ depending on the needs of the user.

Referring again to FIGS. 28-31, the illustrated exemplary holder 1013 isprovided with sixty four total cells 1033 organized into four rows of 16cells 1033. In the examples, the organization of cells 1033 is identicalto the organization of cells 41 of exception storage apparatus 43 ofautomated dispensing machine 45 described above in connection with FIGS.18-21C. Exemplary holder 1013 is configured and arranged such that eachcell 1033 outlet 1039 is in registry with (i.e., aligned with) acorresponding cell 41 of exception storage apparatus 43 permittingdirect movement of medicaments 11 from holder 1013 into exceptionstorage apparatus 43 in the same manner as cells 33 are aligned withcells 41 as shown in the example of FIGS. 21A-21C. Cells 1033 can be ofany number and need not be arranged in rows and columns as illustrated.For example, cells 1033 could be arranged in any number of rows,columns, or other patterns to correspond to cells 41 of an exceptionstorage apparatus 43 other than as illustrated or for use intransferring medicaments 1011 or items to a device other than exceptionstorage apparatus 43.

Holder top 1021 is preferably provided with human-readable indicia 1047identifying each cell 1033. In the examples, indicia 1047 is an integerfrom 1 to 64 proximate each cell 1033. Other types of indicia 1047 maybe used, such as alpha-numeric indicia.

Holder 1013 further includes at least one indicator 1049″ for each cell1033, of which indicator 1049″ is representative. For purposes ofsimplicity and brevity, each indicator 1049″ of holder 1013, 1013′ isindicated by reference number 1049″, it being understood that eachindicator 1049″ has the same structure in the examples. Each indicator1049″ is located through holder 1013 body 1019 from bottom 1023 to top1021. In the example, indicators 1049″ are organized into four rows of16 indicators 1049″corresponding to the pattern of cells 1033 of holder1013 and positioned so as to be below each cell 1033 and approximatelycentered on each cell 1033. One indicator 1049″ is provided for eachcell 1033 for a total of sixty four indicators 1049″ in the example,although other indicator types and arrangements may be provided asdescribed herein.

Each indicator 1049″ may be a visible information source in the form ofa selectively-operable light pipe. A light pipe means or refers to alight-transmissive device used for transporting or distributing naturalor artificial light. The indicators 1049″ may be of molded plastic,fiber optics, or other light-communicating materials. Each indicator1049″ (and indicators 1049′, 1049′″ described herein) includes a firstend 1054, or inlet, a body 1056, and a second end 1058, or outlet. Light(i.e., visible information) from a light source such as an LED indicator1049 which enters the inlet 1054, is communicated through body 1056 tooutlet 1058. When docked at docking station 1015, indicator 1049″ isaligned with docking station indicators 1049, 1049′ to receive andcommunicate light. Indicators 1049, 1049′, 1049″ communicate light sothat the light is visible to a user on holder 1013 top 1021.

Holder 1013 further includes a pair of front legs 1051 and a pair ofrear legs 1053 depending from holder 1013 bottom side 1023. Leg pairs1051, 1053 may be provided to support holder 1013 on a surface (such asworkstation counter top 1085).

Referring to the bottom plan view of FIG. 31, exemplary holder 1013further includes a planar shuttle member 1055 positioned in planar track1057 in holder 1013 proximate each cell 1033 outlet 1039. Shuttle member1055 includes openings 1059 and a pull 1061 which permits the technicianor pharmacist to grasp shuttle member 1055 with his or her hand and topull or push shuttle member 1055.

In the example, shuttle member 1055 is movable between a first positionshown in FIGS. 28, 28A, and 31 in which shuttle member 1055 covers andcloses each cell 1033 outlet 1039 in the same manner as illustrated inFIG. 21A for holder 13 and a further position in which the shuttlemember 1055 openings 1059 are in alignment with each cell 1033 outlet1039, thereby opening each cell outlet 1039 permitting medicaments 1011to drop from each cell 1033 into a corresponding cell of exceptionstorage apparatus 43 in the same manner as illustrated in FIG. 21C forholder 13. The first position of shuttle member 1055 is referred toherein as a “cell-closed position” and the further position of shuttlemember 1055 is referred to herein as a “cell-opened position.” Inbetween these positions, the cells 1033 are partially open permittingmedicaments 1011 to start to fall from cells 1033. This intermediateposition would be the same as for holder 13 illustrated in FIG. 21B.

In the embodiments, shuttle member 1055 serves as a sliding gate orclosure, opening and closing each cell 1033 as shuttle member 1055 movesand slides between the cell-closed (e.g., FIG. 21A) and cell-openedpositions (e.g., FIG. 21C). Shuttle member 1055 thereby blocks each celloutlet 1039 in the cell-closed position permitting a medicament 1011 tobe loaded into each cell 1033 for organizing and storage and furtheropens each cell outlet 1039 permitting each medicament 1011 to bedischarged from holder 1013 for loading into exception storage apparatus43 in the same manner as described in connection with holder 13 andFIGS. 21A-21C above.

Body 1019 also preferably includes a bar code 1132 (FIG. 24) with a codeuniquely identifying holder 1013. Holder 1013 may be made of anysuitable material or combination of materials. Preferably, body 1019 ismade of plastic material construction for reasons of ease ofmanufacture, low weight and portability, ease of cleaning, and cost.Indicators 1049″ are preferably light pipe-type indicators but maycomprise other types of indicators.

Referring now to FIGS. 45-47 and FIGS. 37-39 and FIG. 52, exemplaryholder 1013′ of system 1010′ will next be described. As illustrated,holder 1013′ is a portable blister-package-type container for managingand organizing medicaments 1011. In the examples, a loaded holder 1013′can be delivered to a patient as an integrated container includingmedicaments 1011 as required to fulfill the patient's prescriptionorder. For simplicity and brevity, like reference numbers of holder 1013are used to identify like parts of holder 1013′.

Exemplary holder 1013′ includes a body 1019, a top and a bottom 1021,1023, a front and a rear side 1025, 1027, and a left and a right side1029, 1031. Holder 1013′ further includes cells, of which cell 1033 isrepresentative. Holder 1013 cells 1033 are referred to by some inindustry as “wells” and the terms cells and wells are usedinterchangeably herein. Each cell 1033 is defined by a wall 1035, ofwhich wall 1035 is representative. In the example of holder 1013′, cells1033 and walls 1035 have an elongate “D” shape (in cross-section), whichis a shape employed in certain blister-package-type containers. Othercell 1033 and wall 1035 shapes may be utilized. For purposes ofsimplicity and brevity, each cell 1033 of blister package 1013 isindicated by reference number 1033 and each wall is indicated byreference number 1035, it being once again understood that each cell1033 has the same structure in the example. Exemplary holder 1013′ has atray-like appearance in that it is a flat, shallow container used forcarrying, holding, and organizing items which are preferably medicaments1011.

Each wall 1035 defines a cell 1033 upper opening, or inlet 1037 and acell bottom 1040. As shown in the examples, the cell inlets 1037 extendthrough, and are included in and along, the body top 1021. In theembodiments, medicaments 1011 are loaded into each cell 1033 throughinlet 1037.

In the embodiments, each cell 1033 is identical. However, it is possiblethat cells 1033 of holder 1013′ may have a structure which is notidentical and which may differ depending on the needs of the user. Forexample, certain cells 1033 of holder 1013′ could have a depth or across-sectional shape which differs from the depth and cross-sectionalshape of other cells of holder 1013′.

Referring further to FIGS. 45-47 and 37-39 each illustrated exemplaryblister package 1013′ includes thirty two total cells 1033 organizedinto eight rows of four cells 1033. The illustrated organization ofcells 1033 is merely exemplary. Cells 1033 can be of any number and neednot be arranged in rows and columns as illustrated. For example, cells1033 could be arranged in any number of rows and columns, in a circularpattern, or in any other suitable arrangement.

A closure 1042 may be affixed to body 1019 to cover cell inlets 1037 andprovide an integrated and sealed blister-package-type holder 1013′.Closure 1042 may be of a thin foil, paperboard, or other suitablematerial capable of closing holder 1013′. Closure 1042 may be joined tobody 1019 by any suitable means including adhesive(s), sonic bonding(i.e., plastic welding), and heat sealing. Holder 1013′ protectsmedicaments 1011 and other items therein from contact with the outsideenvironment and provides a convenient container with which to deliverthe contents of the holder 1013′ to the patient or other end user.

Before or after loading of holder 1013′, an adhesive-backed label 1044may be affixed to holder 1013′. Label 1044 may include all informationneeded for use of holder 1013′ as a self-contained, sealed,patient-specific container which may include a course of medicaments1011 as prescribed by a physician. Alternatively, holder 1013′ mayinclude a non-patient-specific label (not shown) generally identifyingthe medicament 1011 contents so that the holder 1013′ can besubsequently delivered to any patient requiring the medicaments 1011.

Label 1044 may include any suitable information including patient name1046 (e.g., “John Doe”), physician name 1048 (“Dr. Jane Smith”),medicament name, strength, and NDC number 1050 (e.g., “Naproxen Anaprox375 nig”, 11-digit NDC “00093014801”), instructions 1052 and a uniquebarcode 1054. In addition or as a substitute for label 1044, theaforementioned information may be printed directly on closure 1042,preferably before joining closure 1042 to body 1019.

Body 1019 may, for example, be made of material capable of having thecells 1033 formed therein by processes such as thermoforming or coldforming. In embodiments, a preferred material for body 1019 is polyvinylchloride (PVC) sheet. The PVC sheet may be between about 0.008 and about0.012 inches in thickness, as an example. PVC sheet is inexpensive andcan be thermo-formed to form cells 1033. The material selected for body1019 may be selected so that cells 1033 are collapsible by pushing witha human finger. Closure 1042 is preferably breakable so that amedicament 1011 within cell 1033 can be pushed through closure 1042 andout of holder 1013′ for use. In other embodiments, body 1019 may be of arelatively thicker plastic sheet material which does not collapse, thusforming a rigid tray. In such an embodiment, closure 1042 may be of a“peel-off” type to permit access to medicaments 1011 or other itemswithin cells 1033.

Body 1019 may be light-transmissive, and preferably transparent, therebypermitting the contents of each cell 1033 to be seen through bottom 1023without opening holder 1013′. Body 1019 could also be translucent oropaque as required, for example for ultra-violet light protection ofmedicaments 1011 therein.

Closure 1042 affixed to holder 1013′ may include human-readable indicia(not shown) identifying each cell 1033 and/or providing information toassist the patient comply with the physician's instructions. Closure1042 is a suitable surface for indicia because it can have a relativelylarge surface area suitable for printing. For example, indicia onclosure 1042 could include a day of the week and/or time at which aparticular medicament 1011 is to be removed from blister-package-typeholder 1013′ and taken by the patient. Other types of indicia andinformation may be provided or used.

Referring next to FIGS. 23-28A, 36 and FIGS. 37-44B, 50 and 52, thereare shown embodiments of docking stations 1015, 1015′ capable of usewith a respective exemplary holder 1013, 1013′. Each docking station1015, 1015′ may be placed on a counter top 1085, such as the counter top1085 at a workstation in a pharmacy, long-term care facility, hospital,or other facility.

Each exemplary docking station 1015, 1015′ preferably includes housing1089 including top and bottom walls 1091, 1093, left and right sidewalls 1095, 1097 and front and rear walls 1099, 1101. As illustrated inFIGS. 23-28A, docking station 1015 may include a pair of rear legs 1102,1104 attached to rear wall 1101 which raises the rear wall 1101 so thatdocking station 1015 is angled down toward front wall 1099.

As illustrated in FIGS. 37-39 and 41, exemplary docking station 1015′ issupported with a cradle 1106. Cradle 1106 may be made of a single pieceof metal sheet or other material and may have a rear leg 1108 which maybe elongated to angle docking station 1015′ toward front wall 1099, adeck 1110 on which docking station 1015′ rests, and a front retainer1112 against which front wall 1099 rests to retains docking station1015′ on cradle 1106. Angling docking stations 1015, 1015′ toward frontwall 1099 may help a technician, pharmacist, or other user better seemedicaments 1011 or other items at the moment the medicament 1011 entersthe holder 1013, 1013′ and in an optional subsequent verificationprocess.

As illustrated in FIGS. 24-27, and 37-38 and 41, exemplary dockingstations 1015, 1015′ may further include structure permitting sensorguide 1301, 1301′ to be removed from a holder 1013, 1013′ andtemporarily stored on docking station 1015, 1015′. Docking station 1015may include a seat 1114 formed by uprights 1116 and rear legs 1102,1104. Seat 1114 is provided to temporarily hold sensor guide 1301upright away from holder 1013. In the example of docking station 1015′,sensor guide 1301′ may simply be placed on end resting against rear wall1101 of docking station 1015′. These arrangements permit holder 1013,1301′ to be docked and undocked from docking station 1015, 1015′, permitoptional verification of a loaded holder 1013, and permit use of systems1010, 1010′ without sensor guide 1301, 1301′ as described herein.

In the embodiment of system 1010 illustrated in FIGS. 23-28A, dockingstation 1015 housing 1089 is generally rectangular in shape, althoughany shape may be utilized. Housing 1089 has a generally planar top wall1091 and may include resilient pads (not shown) on which holder 1013rests when docked at docking station 1015.

Referring to FIGS. 23-27, holder 1013 and docking station 1015 mayinclude locating structure which cooperates to enable or facilitaterepeatable docking of holder 1013 with docking station 1015 in a singleand identical position. As illustrated in FIGS. 23-27, such locatingstructure may comprise a pair of female alignment pin receivers 1063 onopposite sides 1029, 1031 of holder 1013 and a pair of male alignmentpins 1065 on docking station 1015. Male alignment pins 1065 are receivedin a respective receiver 1063 when holder 1013 is docked with dockingstation 1015. The mechanical interconnection of receivers 1063 andcorresponding pins 1065 locates holder 1013 at docking station 1015 in asingle and identical position and constrains holder 1013 from lateralmovement. The exemplary locating structure permits plural differentholders 1013 to be repeatedly docked in a single and identical positionwith a single docking station 1015.

Locating structure for holder 1013 may further include an alignmentguide 1223 (FIG. 26) along docking station 1015 housing 1089 rear wall1101. Alignment guide 1223 is received in recess 1225 provided in holder1013. Alignment guide 1223 cooperates with alignment pin receivers 1063and male alignment pins 1065 to limit lateral movement of holder 1013.

In the embodiment of FIGS. 37-39, 41-44B, docking station 1015′ housing1089 is generally rectangular in shape although, as with docking station1015, any shape may be utilized. In this illustrated embodiment, housing1089 top wall 1091 is preferably planar and includes a plurality ofpockets 1229. For convenience and brevity, select pockets are indicatedby reference number 1229, it being understood that the other pocketshave the same structure. Pockets 1229 are provided to receive cells 1033of holder 1013′ nested therein for purposes of locating holder 1013′ ata known position on docking station 1015′.

In the embodiments, pockets 1229 have an arrangement or pattern whichmatches the pattern of holder 1013′ cells 1033. Each pocket 1229 isdefined by a wall 1231, of which wall 1231 is representative. Each wall1231 defines a pocket upper opening 1233. In the example of dockingstation 1015′, pockets 1229 have an elongate “D” shape (incross-section) which matches and is complementary to the elongate “D”shape of holder 1013′ cells or wells 1033. In the embodiments, the cells1033 of holder 1013′ are inserted into pockets 1229. Walls 1035 definingcells 1033 may be sized to fit snugly within a respective pocket 1229.The complementary elongate “D” shapes of the cells 1033 and pockets 1229may serve as a type of key which helps to position holder 1013′ in asingle orientation in docking station 1015′. Preferably, holder 1013′body 1019 and bottom 1023 rest on top wall 1091 of housing 1089 duringthe process of loading medicaments 1011 into each cell 1033 through cellinlet 1037.

The aforementioned arrangement limits lateral movement of holder 1013′in any lateral direction. Since holder body 1019 and bottom 1023preferably rest on top wall 1091, holder 1013′ is effectively held inplace in position to receive the medicaments 1011 or other items thereinwhich is of particular importance when seeking to load holder 1013′accurately. This also locates holder 1013′ at a known position which isimportant so that the location of each cell 1033 is known to system1010′ as previously described in connection with system 1010.

In the example, docking station 1015′ is configured to simultaneouslydock from one to four separate and distinct holders 1013′. Dockingstation 1015′ illustrated in FIGS. 37-39 and 44A-44B includes fourgroups of thirty two total pockets 1229 for a total of 128 pockets 1229.Each of the four groups is organized into four columns of eight pockets(8 rows.times.4 columns) 1229 a, 1229 b, 1229 c, 1229 d to accommodate aholder 1013′ having 32 cells 1033 in a pattern which matches that of agroup of pockets 1229 a-1229 d. As illustrated in FIGS. 38-39 and 42A, aholder 1013′ is shown nested in one of the groups of pockets 1229 a.

Docking station 1015′ top wall 1091 is preferably provided withhuman-readable indicia 1103 identifying each cell pocket 1229. In theexamples, indicia 1103 is proximate each pocket 1229 and is an integerfrom 1 to 32 for each group of pockets 1229. Other types of indicia maybe used, such as alpha-numeric indicia.

It can be important that docking station 1015′ provide adequate supportfor holder 1013′ during loading or subsequent verification. Providingsupport can be important because the material used for holder 1013′ body1019 is frequently quite thin and pliant. In the example of dockingstation 1015′ top wall 1091 and pockets 1299, particularly if cells 1033are snugged against pockets 1229, provide multiple points of supportacross holder 1013′ body 1019 and cells 1033. The support provided bydocking station 1015′ top wall 1091 and pockets 1229 ensures that such aholder 1013′ will not collapse during loading, potentially resulting inloss of costly medicaments 1011.

As illustrated in FIGS. 42-43, yet another benefit of pockets 1229 isthat they permit holder 1013′ cells 1033 to fit within docking station1015′ with holder 1013′ top 1021 flush and essentially co-planar withdocking station 1015′ top wall 1091. Since holder 1013′ is closelyagainst docking station 1015′, sensor guide 1301′ may be placed closelyagainst holder 1013′ to “sandwich” holder 1013′ between docking station1015′ and sensor guide 1301′ so that the structure of sensor guide 1301′continuously guides medicaments 1011 all the way into the appropriatecell 1033 as described herein. Thus, pockets 1229 serve to locate,potentially support, and permit full seating of holder 1013′ withdocking station 1015′ in the example.

As previously described, it is possible that holder 1013′ cells 1033 forthe blister-package-type container can have a structure other than therows and columns illustrated or in which there are differences instructure amongst the cells. Previously-described examples include cells1033 with different depths or with different cross-sectional shapes. Toaccommodate these different cell 1033 arrangements and types, holder1013′ pockets 1229 can be sized, shaped, and configured to match thepattern of cells 1033.

In the example, holder 1013′ is illustrated with pockets 1229 integratedinto housing 1089 so that holder 1013′ is a single unit. In otherembodiments, docking station 1015′ could have a generally planar topwall 1091 and indicators 1049 and/or 1049′, but sized, shaped, andconfigured to receive a removable adapter (not shown) including thepockets 1229 in a pattern which could be identical to the pattern of 128pockets 1229 illustrated in FIGS. 38-40 and 44A-44B. The adapter couldinclude an indicator identical to indicator 1049′ next to each pocket1229 and in alignment with an indicator 1049 or 1049′ when the adapteris mounted on the docking station. Plural different adapters could beutilized interchangeably with the same docking station 1015′, each witha pocket 1229 pattern to accommodate a different holder 1013′. It ispossible, therefore, that a single docking station 1015′ couldaccommodate multiple different types of holders 1013′ by means of anadapter.

Referring to the schematic block diagram of FIG. 53, exemplary holder1013, 1013′ and docking station 1015, 1015′ may be provided withapparatus for uniquely identifying holder 1013, 1013′ to docking station1015, 1015′ and system. Positive identification of holder 1013, 1013′enables the user to precisely control loading of appropriate medicaments1011 into holder 1013 and 1013′ permits the user to maintain moreaccurate records of medicaments 1011 which have been loaded anddispensed.

In such embodiments, holder 1013, 1013′ may include an identificationelement 1081 and docking station 1015, 1015′ may include anidentification element detector 1083 as shown in FIG. 53. The identifierelement 1081 may, for example, consist of a radio frequencyidentification tag (RFID) and the detector 1083 may be an RFID taureader (i.e., an interrogator) on docking station 1015, 1015′. Theexemplary RFID tag 1081 may be re-writable or read-only, as desired.Exemplary RFID reader 1083 provided on docking station 1015, 1015′detects information embedded on the RFID tag 1081. Information embeddedin RFID tag 1081 identifying holder 1013, 1013′ may be used by system1010, 1010′ to control the medicament-dispensing process. The uniqueidentifier of the RFID tag 1081 could be matched to a file for thepatient or holder 1013, 1013′ in database 1371 to associate such holderwith the patient's prescription order. By way of further example, holder1013, 1013′ may include other types of identifier elements, such as abar code 1132 (FIG. 24) and detector is a barcode scanner 1131 toidentify holder 1013, 1013′.

For embodiments utilizing holder 1013′, an identification elementdetector 1083 may be provided apart from docking station 1015, 1015′ atany appropriate physical location at which identification of holder1013′ is desired. For example, an identification element detector 1083could be provided at the patient's bedside to identify holder 1013′ andconfirm that holder 1013′ is for the intended patient. Detection of theidentification element 1081 corresponding to the holder 1013′ intendedfor the patient, could be used to prompt the care giver to deliverholder 1013′ to the patient. Conversely, if an incorrect holderidentification element 1081 is detected by detector 1083, the care giverwould not provide the holder 1013′ to the patient.

For embodiments utilizing a holder 1013, an identification elementdetector 84 may be provided on automated dispensing machine 45 (FIGS.19, 20) as previously described. In the example utilizing RFID tags,detector 84 may comprise an RFID reader. If the correct holder 1013identification element 1081 is detected by detector 84, the technician,pharmacist, or other user is prompted to transfer medicaments 1011 fromholder 1013 to exception storage apparatus 43. Conversely, if anincorrect holder identification element 1081 is detected by detector 84,the technician, pharmacist, or other user is prompted to not transfermedicaments 1011 from holder 1013 to exception storage apparatus 43.

Referring to FIGS. 28-28A and 36 and FIGS. 38-44B and 50-52, exemplarydocking stations 1015, 1015′ include a plurality of indicators 1049,1049′ within housing 1089. Indicators 1049 may be lamp-type indicatorswhich emit or communicate light energy as indicated in FIGS. 28-28A and42-42A. Exemplary indicators 1049 separately represent individual lightsources and, collectively, represent a light source. Indicators 1049 arepreferably directed toward docking station top wall 1091 and areprovided in a pattern which matches the pattern of the cells 1033 ofholders 1013, 1013′ such that at least one indicator 1049 is providedfor (i.e., associated with) each cell 1033. Preferably, each indicator1049 is a light-emitting diode (LED), although it is envisioned thatother types of indicators 1049 may be used. Indicators 1049 may all bemounted on a single circuit board 1237 within housing 1089. Circuitboard 1237 represents circuitry operatively connected to controller 1017enabling controller 1017 to selectively control indicators 1049, 1049′as discussed herein.

Referring to FIGS. 28-28A and 36 and FIGS. 42-42A and 44A-44B, exemplarydocking stations 1015, 1015′ further include a plurality of indicators1049′ within housing 1089 between indicators 1049 and top wall 1091 ofhousing 1089. In the examples, each indicator 1049′ may be a visibleindicator in the form of a selectively-operable light pipe of the typedescribed in connection with indicators 1049″ of holder 1013 and thedescription of such indicators 1049″ is incorporated herein byreference. Indicators 1049′ include first and second ends 1054, 1058,and body 1056. Each indicator 1049′ is aligned with an indicator 1049and receives light from indicator 1049 in first end 1054. Indicator1049′ body 1056 communicates the light through housing 1089 so thatlight is visible to a user from indicator 1049′ second end 1058 at topwall 1091 of docking station 1015, 1015′. In the example of system 1010,light from indicators 1049′ is communicated to aligned holder 1013indicators 1049″ when the holder 1013 is docked. In the example ofsystem 1010′, light from indicators 1049′ is viewable by a user next to,or proximate, a pocket 1229.

In the docking station embodiment 1015, indicators 1049, 1049′ are mostpreferably provided in a pattern which matches the pattern of holder1013 cells 1033 and indicators 1049″ of holder 1013 such that at leastone indicator 1049, 1049′ is provided for (i.e. associated with) eachcell 1033. In the example, indicators 1049, 1049′ are organized intofour rows of 16 indicators 1049, 1049′ corresponding to the pattern ofcells 1033 of holder 1013 and positioned so as to be below each cell1033 and approximately centered on each cell 1033 when a holder 1013 isdocked at docking station 1015.

When docked, holder 1013 is seated or docked on docking station 1015such that indicators 1049″ of holder 1013 are in alignment withindicators 1049, 1049′ of docking station 1015 and light energy fromindicators 1049, 1049′ is communicated through a corresponding alignedholder 1013 indicator 1049 to the top wall 1021 of holder 1013.

In the docking station embodiment 1015′, holder 1013′ is preferably acontainer of a blister-package-type and does not include indicators1049″. In this embodiment, indicators 1049, 1049′ are most preferablyprovided in a pattern on docking station 1015′ which matches the patternof holder 1013′ cells 1033 such that at least one indicator 1049, 1049′is provided for (i.e., associated with) each cell 1033 when a holder1013′ is docked in one of the group of pockets 1229 a-1229 d. In thisexample, indicators 1049, 1049′ are organized into four groups of 32total pockets 1229 for a total of 128 indicators 1049, 1049′. Each ofthe four groups of indicators 1049, 1049′ is organized into four rows ofeight indicators 1049, 1049′, one group corresponding to each group ofpockets 1229 a, 1229 b, 1229 c, 1229 d. In this example, indicators1049, 1049′ are positioned so as to be above each pocket 1229 andapproximately centered on each pocket 1229 with the effect being thatindicators 1049, 1049′ are positioned slightly above and centered oncells 1033 of a docked holder 1013.

The foregoing examples illustrate that the location of indicators 1049,1049′ is not critical. Indicators 1049, 1049′ may be provided in variouslocations to communicate visible information to assist the technician,pharmacist, or other user to load a medicament 1011 in the correct cell1033. In other embodiments, it is envisioned that indicators (e.g.,indicators 1049) could be located entirely off of docking station 1015,1015′ with the visible information from indicators 1049, projected ontoholder 1013, 1013′, by for example, lasers, mirrors, projectors, orfiber optics.

Exemplary indicators 1049, 1049′, are selectively-operable in that, theyselectively communicate light energy, which is a type of visibleinformation. When an indicator 1049 is activated, the aligned indicator1049′ communicates light information to top 1021 of holder 1013′.Conversely, when an indicator 1049 is not activated, the alignedindicator 1049′ does not communicate light information to top 1021 ofholder 1013. The preferred light energy provided by indicators 1049,1049′ may be viewable to a user on the holder 1013, 1013′ proximate eachcell 1033 to indicate the cell 1033 into which a medicament 1011 orother item is to be placed.

Preferably, the light energy provided by indicators 1049, 1049′ isviewable to a user on holder 1013′ of a blister-package-type becauseholder 1013′ body 1019 may be made of a transparent plastic material.The light energy is viewable through the light-transmissive transparentplastic material of body 1019 along top 1021 of holder 1013′. In otherembodiments, an opening (not shown) in body 1019 could be providedproximate each cell 1033. Each opening would be in alignment with one ofthe indicators 1049′ when holder 1013′ cells 1033 are nested withinpockets 1229 of docking station 1015′.

Referring next to FIGS. 23-28A and 32-36 and FIGS. 37-43 and 48-52, asensor guide 1301, 1301′ may optionally be provided to detect thephysical presence of medicaments 1011 or other items loaded into cells1033 of holder 1013, 1013′. In the example, sensor guide 1301, 1301′serves as a guide to aid in correct loading of a holder 1013, 1013′.Sensor guide 1301, 1301′ provides positive feedback to controller 1017indicative that a medicament 1011 or other item has been loaded into thecorrect cell 1033 of holder 1013, 1013′. Sensor guide 1301, 1301′ canprovide feedback for a medicament 1011 overcount and undercount. And,sensor guide 1301, 1301′ can provide positive feedback indicative that amedicament 1011 or other item has been loaded into an incorrect cell1033 of holder 1013, 1013′.

Responsive to detection of an erroneous loading of a medicament 1011 bysensor guide 1301, 1301′, controller 1017 can generate a signal. Thesignal may include an error description presented to a user on videodisplay 1125 as described in connection with FIGS. 60-66 and 79-85. Theerror description may include a description of an overcount, anundercount, and an incorrect cell and can include instructionsdescribing the error and how to correct the error.

The information provided by sensor guide 1301, 1301′ to controller 1017can be used be used for numerous purposes, including to create a recordthat the holder 1013, 1013′ was loaded properly and to make loading moreefficient.

In the embodiments illustrated by FIGS. 23-28A and 32-36 and FIGS. 37-43and 48-52, sensor guide 1301, 1301′ may overlie holder 1013, 1013′.Medicaments 1011 or other items are detected as they pass through sensorguide 1301, 1301′ during loading into a cell 1033 to alert the user inthe event of an error so that corrective action can be taken. In theembodiments, exemplary sensor guides 1301, 1301′ have essentially thesame structure and operation, except that each sensor guide 1301, 1301′is sized, shaped, and configured to function with the respective holder1013, 1013′ and docking station 1015, 1015′.

Exemplary sensor guide 1301, 1301′ may include a body 1303, a top and abottom 1305, 1307, a front and a rear side 1309, 1311, and a left and aright side 1313, 1315. Exemplary sensor guide 1301, 1301′ has a planar,generally rectangular shape which corresponds to docking station 1015,1015′. Bottom 1307 is preferably generally planar to permit sensor guide1301, 1301′ to abut holder 1013 or 1013′ top 1021. Sensor guide 1301,1301′ includes openings 1317, each defined by a wall 1319. Forconvenience, only certain of openings and walls 1317, 1319 are indicatedby reference numbers, it being understood that the other openings andwalls are the same in the embodiments.

In the example of sensor guide 1301, openings 1317 and walls 1319 havean oval shape which matches and aligns with the oval shape of holder1013 cells 1033 and cell inlets 1037. In the example of sensor guide1301′, openings 1317 and walls 1319 have an elongate “D” shape whichmatches and aligns with the elongate “D” shape of holder 1013′ cells1033 and cell inlets 1037 and pockets 1229 of docking station 1015′.Other shapes of openings 1317 and walls 1319 may be utilized. Thealigned cell 1033 walls 1035 and sensor guide opening 1317 walls 1319form a continuous guide surface from openings 1317 into cell 1033,particularly if holder top 1021 and sensor guide bottom 1307 abut, whichconstrains medicaments 1011 to enter and stay in the cell 1033 intowhich they are placed by the user (e.g., a technician or pharmacist).

Sensor guide 1301 may further include four legs 1316, one leg 1316 ateach corner of sensor guide 1301. Legs 1316 may be seated in a recess1318 in holder 1013 top wall 1021 to locate sensor guide 1301 in asingle repeatable position on holder 1013 and docking station 1015.

As is well illustrated in FIGS. 28-28A and 42-42A, each sensor guide1301, 1301′ opening 1317 is aligned with a corresponding cell 1033 of aholder 1013 or 1013′. In the embodiments of FIGS. 23-28A and 32-36,sensor guide 1301 is sized for use with a holder 1013 which includessixty four cells 1033 as previously described. In this example, sensorguide 1301 is provided with 64 openings 1317 organized into a pattern offour rows of 16 openings (4 rows.times.16 columns) 1317 to match thepattern of the sixty four cells 1033 of holder 1013.

In the embodiment of FIGS. 37-52, sensor guide 1301′ is sized for usewith from one to four holders 1013′. In this example, sensor guide 1301′is provided with 128 openings 1317 organized into a pattern of fourgroups of 32 openings (8 total rows.times.16 total columns) 1317 a, 1317b, 1317 c, 1317 d to match the pattern of the 128 pockets 1229 a-1229 dof docking station 1015′.

Sensor guide top 1305 is preferably provided with human-readable indicia1323 identifying each cell 1033. In the example, indicia 1323 is aninteger from 1 to 32 for each group of 32 openings 1317 proximate eachcell 1033. Other types of indicia may be used, such as alpha-numericindicia.

As illustrated in FIGS. 28-28A, exemplary sensor guide bottom 1307 mayrest directly against holder 1013 top 1305 with legs 1316 seated inrecess 1318 in holder 1013 top wall 1021. As illustrated in FIGS. 37-43,sensor guide 1301′ bottom 1307 may rest directly against holder 1013′top 1021. Top 1021 is preferably a flat planar surface in a blisterpackage embodiment. Each sensor guide opening 1317 is in alignment withone of the holder 1013′ cells 1033. In other embodiments, sensor guide1301, 1301′ may be spaced from holder 1013 or 1013′. Sensor guide 1301of system 1010 may include a recess 1225 which receives pull 1061 ofholder 1013 when sensor guide 1301 rests on holder 1013.

Referring to FIGS. 38-39, 43-43B and 49B, exemplary sensor guide 1301′includes four interlock switches 1320, one for each of the four groupsof pockets 1229 a-1229 d and openings 1317 a-1317 d to indicate tocontroller 1017 that a holder 1013′ is docked, or not docked, at one ofsuch positions of docking station 1015′. Two of the four interlockswitches 1320 are illustrated in FIGS. 43-43B, it being understood thateach other interlock switch 1320 has the same structure and operation.Interlock switches 1320 include a spring-loaded (e.g., biased) plunger1322 which extends toward pocket 1324 in top 1021 of docking station1015′.

FIGS. 43A and 43B illustrate sensor guide 1301′ seated on dockingstation 1015′. In FIG. 43A a holder 1013′ is docked at pockets group1229 a and no holder 1013′ is docked at pockets group 1229 b. In FIG.43A, body 1019 of docked holder 1013′ covers pocket 1324 in dockingstation 1015′. Also in FIG. 43A, plunger 1324 contacts body 1019 andcloses interlock switch 1320. Closure of interlock switch 1320 generatesa signal to controller 1017 indicating that a holder 1013′ is docked inthe associated one of the group of pockets group, in this examplepockets group 1229 a. Controller 1017 permits operation of indicators1049, 1049′, 1049′″ for pockets 1229 and openings 1317 for pockets group1229 a and openings group 1317 a.

As illustrated in FIG. 4B, no holder 1013′ is docked at pockets position1229 b and pocket 34 of docking station 1015′ is uncovered by a holder1013′. In this state, plunger 1320 is biased to extend into pocket 1324and, consequently, interlock switch 1320 remains open. When interlockswitch 1320 is open, controller 1017 disables activation of indicators1049, 1049′, 1049′ for the associated group of pockets and openings,which is pockets group 1229 b and openings group 1317 b in this example.Consequently, a user cannot be prompted by indicators 1049, 1049′,1049′″ to load a medicament 1011 where no holder 1013′ is docked.

Sensor guides 1301, 1301′ may include structure to ensure that they arelocated in a single, repeatable position on holder 1013, 1013′. Sensorguide 1301 preferably includes legs 1316 and interference between legs1316 and recess 1318 locates sensor guide 1301, in a single position.

Referring now to FIGS. 28-28A and 34-36 and FIGS. 42-42A and 50-52, asensor module 1325 may be provided within sensor guide 1301, 1301′ foreach sensor guide opening 1317 to detect the physical presence of amedicament 1011 or other item which falls through sensor module 1325.For convenience and brevity, select modules are indicated by referencenumber 1325, it being understood that the other modules have the samestructure and operation in the examples.

As illustrated in FIG. 34, sensor guide 1301 may include 64 sensormodules 1325, one for each opening 1317. Like openings 1317, sensormodules 1325 are arranged in four rows of 16 sensor modules 1325 andeach sensor module 1325 is aligned with an opening 1317.

As illustrated in FIG. 50, sensor guide 1301′ may include 128 sensormodules 1325, one for each opening 1317. In this example, sensor modules1325 are organized into a pattern of four groups of 32 total sensormodules (8 total rows.times.16 total columns) 1325 a, 1325 b, 1325 c,1325 d. Each of the four groups of sensor modules 1325 is organized intoeight rows of four sensor modules 1325, one group corresponding to eachgroup of pockets 1229 a, 1229 b, 1229 c, 1229 d. In this example, eachsensor module 1325 is aligned with an opening 1317 of sensor guide1301′.

Referring to FIGS. 28-28A, 34-37, 42-42A, and 50-52, an exemplary sensormodule 1325 may include a first housing portion 1327 and a secondhousing portion 1329. When assembled, housing portions 1327, 1329include an opening 1331 through which a medicament 1011 or other itempasses.

A pair of infrared (IR) senders 1333 are positioned at one end of sensormodule 1325 directed into opening 1331 and an infrared (IR) receiver1335 is spaced from senders 1333 across opening 1331 at an opposite endof sensor module 1325. A lens support 1337 supports first and secondlenses 1339, 1341. First lens covers IR sender 1333 and second lenscovers receiver 1335 protecting sender 1333 and receiver 1335 fromdamage by contact with medicament 1011 or other objects. Lenses 1339,1341 may be made of polycarbonate or other suitableIR-energy-transmissive materials. First lens 1339 preferably permitspassage of IR energy from sender 1333 while blocking ambient lightexternal to sensor guide 1301, 1301′ thereby intensifying the IR energyfrom sender 1333. Second lens 1341 is preferably a narrow slit whichpermits a narrow band of IR energy to contact receiver 1335. Thecollective effect of lenses 1339, 1341 is to minimize false detectionevents that could be caused by shadows or movement of a user's hand neara sensor module 1325.

Each sensor module 1325, and IR sender and receiver 1333, 1335 may beoperatively connected to circuitry in the form of a printed circuitboard 1343. Circuit board 1343 may be connected to docking station 1015,1015′ via a flexible cable 1345. Docking station 1015, 1015′ isoperatively connected to controller 1017 permitting sensor module 1325to send a signal to controller 1017 indicative that a medicament 1011has been detected.

As illustrated in FIGS. 28-28A and 42-42A, during operation, IR sender1333 emits, generates, or outputs a signal in the form of IR energy. TheIR energy is across opening 1331 and through second lens 1341. The IRenergy signal is received through second lens 1341 by IR receiver 1335.When a medicament 1011 or other item passes through opening 1331 betweenIR sender 1333 and IR receiver 1335, IR energy received by IR receiver1335 is momentarily blocked. The decrease in IR energy causes sensormodule 1325 to output a signal in the form of a voltage output changewhich is interpreted by controller 1017 as detection of a medicament1011 or other item passing through sensor module 1323. Pluralmedicaments 1011 can be passed through sensor module 1325 and a separatecount will be registered by controller 1017 for each medicament 1011.

Sensor module 1325 may be mounted within (i.e., inside) sensor guide1301, 1301′ in any suitable orientation. In the example of sensor guide1301, each sensor module 1325 is oriented generally parallel to left andright sides 1313, 1315 of sensor guide 1301 whereas in the example ofsensor guide 1301′ sensor module 1325 is oriented generally parallel tofront and rear sides 1309, 1311 of sensor guide 1301.

It is contemplated that sensor guides 1301, 1301′ may be implemented inembodiments other than the illustrated sensor guides 1301, 1301′. Forexample, sensor guide 1301, 1301′ may be an integral element of dockingstation 1015, 1015′ or holder 1013. In such embodiments, a sensor module1325 may be provided for each cell 1033. An appropriatedata-communication connection, 1343, 1345 may be provided between eachsensor module 1325 and controller 1017.

As illustrated in FIGS. 28-28A and 42-42A, sensor guide opening walls1319 may extend below sensor guide bottom 1307 and be sized to nestwithin a corresponding cell 1033 of holder 1013, 1013′. In such anembodiment, each sensor guide wall 1319 extends into the correspondingcell 1033 of holder 1013, 1013′ and nests into wall 1035 of cell 1033providing a continuous guiding surface from opening 1317 through andinto cell 1033 thus assuring that a medicament 1011 or other item canonly enter the cell 1033 of holder 1013, 1013′ aligned with each opening1317 of sensor guide 1301, 1301′. Such an embodiment would beparticularly useful when spacing between sensor guide 1301, 1301′ andholder 1013, 1013′ is desired. The continuous guide surface formed bywalls 1035, 1319 would prevent unwanted bouncing of a medicament 1011from one cell 1033 to another cell 1033 which could occur when amedicament 1011 or other item is loaded into a cell 1033. Such anembodiment would also help to position sensor guide 1301, 1301′ in thesingle, repeatable position on holder 1013, 1013′.

Sensor guide 1301, 1301′ further includes at least one indicator 1049′″for each cell 1033, of which indicator 1049′″ is representative. (Thesymbol ′″ refers to triple prime.) For purposes of simplicity andbrevity, each indicator 1049′″ of sensor guide 1301, 1301′ is indicatedby reference number 1049′″, it being understood that each indicator1049′″ has the same structure and operation in the example.

Indicators 1049′″ are preferably provided in a pattern which matches thepattern of cells 1033 and indicators 1049′, 1049″ of docking station1015, 1015′ and holder 1013 indicators 1049″ such that at least oneindicator 1049′″ is provided for (i.e., associated with) each opening1317 and cell 1033. In the example, each indicator 1049′″ is locatedthrough sensor guide 1301, 1301′ body 1303 from the top 1305 of sensorguide 1301, 1301′ to the bottom 1307 of the sensor guide 1301, 1301′.

In the example of sensor guide 1301, indicators 1049′″ are organizedinto four rows of 16 indicators 1049′″ corresponding to the pattern ofcells 1033 of holder 1013 and openings 1317 of sensor guide 1301 andpositioned so as to be below each opening 1317 and approximatelycentered on each opening 1317. As illustrated in FIGS. 28-28A, eachexemplary indicator 1049, 1049′, 1049″, 1049′″ for each respective cell1033 is in axial alignment when holder 1013 is docked at docking station1015 and sensor guide 1301 is docked or mounted on top of holder 1013.

Exemplary sensor guide 1301′ includes indicators 1049′″ organized intofour groups of 32 total indicators 1049′″ for a total of 128 indicators1049′″ in the same manner as indicators 1049, 1049′ of docking station1015. Each of the four groups of indicators 1049′″ is organized intoeight rows of four indicators 1049′″, one group corresponding to eachgroup of pockets 1229 a-129 d and openings 1317 a-1317 d. As withindicators 1049, 1049′ of docking station 1501′, indicators 1049′″ arepositioned so as to be above each opening 1317 and approximatelycentered on each opening 1317. As illustrated in FIGS. 42-42A and 50-52.each indicator 1049, 1049′, 1049′″ for each respective cell 1033 is inaxial alignment when holder 1013′ is docked at docking station 1015′ andsensor guide 1301′ is docked or mounted on top of holder 1013′.

In the example, each indicator 1049′″ may be a visible indicator in theform of a selectively-operable light pipe of the type described inconnection with indicators 1049′ and 1049″ of docking station 1015,1015′ and holder 1013 and the description of such indicators 1049′,1049″ is incorporated herein by reference. When sensor guide 1301, 1301′is seated on a docked holder 1013, 1013′, indicator 1049′″ is alignedwith indicators 1049, 1049′, 1049″ (all a visible information source)and receives light, a type of visible information, from such indicators.In the examples, light (i.e., visible information) enters the inlet 1054of indicator 1049″″ and is communicated through indicator body 1056 tooutlet 1058. Since each set of indicators 1049 1049′, 1049″ (for holder1013), 1049′″ is aligned when in condition for operation, indicators1049, 1049′, 1049″, and 1049′″ communicate the light through sensorguide 1301, 1301′ so that light is visible to user along top wall 1305of sensor guide 1301, 1301′ next to, or proximate, an opening 1317 ofsensor guide 1301, 1301′.

The preferred light energy provided by indicators 1049, 1049′, 1049″,and 1049′″ may be viewable to a user on the holder 1013, 1013′ top 1305proximate each cell 1033 to indicate the cell 1033 into which amedicament 1011 or other item is to be placed. The presence or absenceof light energy can be seen by the user at the moment the medicament1011 or other item enters opening 1317 so that the user has a confidencelevel that the medicament 1011 was placed into the correct opening 1317.Such confidence level is heightened further by detection of themedicament 1011 or other item by sensor guide 1301, 1301′.

Sensor guides 1301, 1301′ may be made of any suitable material orcombination of materials. Preferably, body 1303 is made of plasticmaterial construction for reasons of ease of manufacture, low weight,ease of cleaning, and cost. Indicators 1049′″ are preferably lightpipe-type indicators but may comprise other types of indicators. Forexample, indicators may be LEDs, liquid crystal displays (LCD) or othervisible indicators.

As previously mentioned, systems 1010, 1010′ may be used without asensor guide 1301, 1301′. Sensor guide 1301, 1301′ may be seated in itscradle 1106 or against docking station 1015′ and deactivated or systems1010, 1010′ may be provided without a sensor guide 1301, 1301′. Forexample, system 1010′ for loading holders 1013′ of ablister-package-type container can be used without a sensor guide 1301′by simply placing a medicament 1011 directly into a cell 1033 indicatedby indicators 1049, 1049′.

Controller 1017 is operable to selectively operate indicators 1049,1049′, 1049″, and 1049′″ associated with each cell 1033 when holder1013, 1013′ is docked at docking station 1015, 1015′ and sensor guide1301, 1301′ is seated on holder 1013, 1013′. Each set of indicators1049, 1049′, 1049″, and 1049′″ corresponding to each opening 1317, cell1033, and/or pocket 1229 represents a visible information source.Selective operation of indicators 1049, 1049′, 1049″, and 1049′″proximate to a cell 1033 or sensor guide opening 1317 prompts thetechnician, pharmacist, or other user to place each medicament 1011 intothe cell 1033 or opening 1317 associated with the activated indicators1049, 1049′, 1049″, and 1049′″.

As with systems 10, 10′, indicators 1049, 1049′, 1049″, and 1049′″comprise a type of pick-to-light/place-to-light system. Thus, if amedicament 1011 is to be loaded in the cells 1033 designated byhuman-readable indicia 1047 as cells 1, 3, 6, 9, 12, 15, 18, 21, 24, and27, each of the indicators 1049, 1049′, 1049″, and 1049′″ next to suchcells 1033 may be activated communicating to the technician, pharmacist,or other user the specific cells 1033 which should contain thatmedicament 1011. In other embodiments, indicators 1049, 1049′, 1049″,and 1049′ may be deactivated to provide the visible information. In suchan embodiment, indicators 1049, 1049′, 1049″, and 1049′″ may initiallybe activated. Deactivation of just the indicators 1049, 1049′, 1049″,and 1049′″ associated with the cell 1033 into which the medicament 1011or other item is to be placed provides the visible information. Thestate of indicators 1049, 1049′, 1049″, and 1049′″ indicating that amedicament 1011 should be placed into a cell may be thought of as a“yes” state while the state of indicators 1049, 1049′, 1049′″ indicatingthat a medicament should not be placed into a cell 1033 may be thoughtof as a “no” state for the implicit and apparent reason that the user isbeing prompted to either place, or not place, a medicament 1011 into anindicated cell 1033.

Use of a pick-to-light/place-to-light system of indicators 1049, 1049′,1049″, and 1049′″ advantageously communicates information to the user(e.g., a technician or pharmacist) without resort to a set of writteninstructions. A pick-to-light/place-to-light system is far superior towritten instructions because the user need not take his or her eyes offof holder 1013, 1013′ to read the instructions, thereby increasingaccuracy and reducing the time required to load or verify themedicaments 1011 that should be in the holder 1013, 1013′.

In further embodiments, systems 1010, 1010′ may have multi-coloredindicators as described in connection with FIGS. 11A, 11B, and 11C, butimplemented by means of indicators 1049, 1049′, 1049″, and 1049′″. Forexample, indicator 1049 could comprise a single multi-colored indicator1049 for each cell 1033, pocket 1229, and opening 1317. In anembodiment, a multi-colored LED lamp could be used as indicator 1049 andthe voltage could be changed by controller 1017 so that indicator 1049would emit a different color as described previously. Indicators 1049′,1049″, and 1049′″ would operate to communicate the color to a positionon sensor guide 1301, 1301′ next to the associated opening 1317 and cell1033. The color differences could be used to communicate information ofthe type described above in connection with FIGS. 11A, 11B, 11C and theentire description of FIGS. 11A-11C is incorporated herein by reference.

In yet other embodiments of systems 1010, 1010′, multiple sets ofindicators may be provided for each cell 1033 and sensor guide opening1317 (e.g., three sets of indicators 1049, 1049′, 1049″, and 1049′″ foreach cell 1033). Such an embodiment may operate under the control ofcontroller 1017 in the same manner and for the same purposes asdescribed previously in connection with FIG. 11D and the description ofFIG. 11D is incorporated herein by reference.

Also as described previously, controller 1017 can control indicators1049, 1049′, 1049″, and 1049′″ to have a blink pattern indicating themedicament 1011 to be loaded into the associated cell 1033 throughsensor guide opening 1317. A constant blink could indicate that onemedicament 1011 is to be loaded into the cell, two blinks could indicatethat more than one medicament 1011 is to be loaded in that cell 1033.and three blinks could indicate that a half-size medicament is to beloaded in that cell 1033. Controller 1017 can also control operation ofindicators 1049, 1049′, and 1049″ for each cell 1033 for verification ofmedicaments 1011 received in each cell 1033.

Systems 1010, 1010′ may include a controller 1017 as described inconnection with controller 17, but with controller 1017 controllingindicators 1049, 1049′, 1049″, and 1049′″ associated with each cell 1033and opening 1317. For example, systems 1010, 1010′ could operate with acontroller 1017 including a programmable logic controller (PLC) 79 andserver 107 connected thereto for purposes of controlling indicators1049, 1049′, 1049″, and 1049′″ as described in connection with FIGS. 12Aand 12B and the description of such controller 17 embodiments isincorporated herein by reference with respect to controller 1017.

Referring to the schematic block diagram of FIG. 53, controller 1017 foruse with systems 1010, 1010′ is most preferably a client computer 1349(i.e., a processing device) operably connected to data port 1109 ofdocking station 1015, 1015′ and communication link 1111. Client computer1349 may include memory 1113 with a program of instructions 1115residing in memory 1113. Client computer 1349 may be connected via acommunication link 1119 to a pharmacy information system (PIS) 1351residing on server 1353. The PIS 1351 passes each prescription order tosystem 1010, 1010′ and client computer 1349 after the prescription orderis first approved by the PIS 1351. Client computer 1349 then providesoverall control of system 1010, 1010′.

Controller 1017 may further be in data-transmission relationship withsensor guide 1301, 1301′. Detection of a medicament 1011 by each sensormodule 1325 is used by controller 1017 to confirm that a medicament 1011has been placed into the correct cell 1033 and to count the quantity ofmedicaments 1011 placed into each cell 1033 as described below.

Each system 1010, 1010′ further preferably includes a video display1125, keyboard 1127, and mouse 1129 permitting a technician, pharmacist,or other user to input and receive information from client computer 1349of controller 1017 or PIS 1351. A biometric identification device 1130may be provided to permit the technician, pharmacist, or other user tobe identified to the system 1010 or 1010′, particularly when logging onto the system. The biometric device 1130 may be a fingerprint reader,retina scanner, or other suitable device. A bar code scanner 1131 ispreferably operably connected to controller 1017. Video display 1125 ispreferably a touch screen display permitting a technician, pharmacist,or other user to input information to controller 1017 by simply touchingher finger on a desired portion of the display 1125. Bar code scanner1131 may be any off-the-shelf scanner capable of reading a bar code 1133on a container 1135 provided to hold medicaments 1011. Keyboard 1127 maybe an off-the-shelf QWERTY-type keyboard 1127 permitting a user to inputinformation to controller 1017 and system 1010, 1010′.

Exemplary Operation and Use

Systems 1010, 1010′ may be used with or without sensor guide 1301,1301′, although use with sensor guide 1301, 1301′ provides heightenedaccuracy and is preferred.

In embodiments, not including a sensor guide 1301, 1301′ or in which thesensor guide 1301, 1301′ is not activated/utilized and is in the storageposition of FIGS. 24 and 38, systems 1010, 1010′ may be used asdescribed above in connection with FIGS. 14-17, with the informationpresented on the video display 1125 adjusted to conform to the numberand arrangement of cells 1033 of holder 1013, 1013′. The description ofoperation of systems 10, 10′ and FIGS. 14-17 is incorporated byreference with respect to embodiments of systems 1010, 1010′.

More specifically, in exemplary system 1010 holder 1013 is provided withsixty four cells 1033 arranged in four rows of 16 cells 1033 identicalwith holder 13 and the sixty four cells 33 of holder 13. In theexamples, the structure of each holder 13, 1013 and the pattern of thecells 33, 1033 is as required to conform to cells 41 of exceptionstorage apparatus 43 of automated dispensing machine 45 as previouslydescribed. Accordingly, holder 1013 may be loaded and verified in thesame manner as described for holder 13 in connection with FIGS. 14-17with controller 1017 operating indicators 1049, 1049′, 1049″, and 1049′″to provide the visible information directing the user to either load amedicament 1011 into a cell 1033 or to verify that the medicament 1011loaded in each cell 1033 is correct. The result would be a holder 1013that has been loaded and verified as correct for transfer of themedicaments 1011 to automated dispensing machine 45 in the same manneras described in connection with systems 10, 10′.

And, container loading and verification of a holder 1013′ of ablister-package-type may be loaded and verified in the same manner asdescribed for holder 13 in connection with FIGS. 14-17 with holder 1013′docked at docking station 1015′ and controller 1017 operating indicators1049, 1049′, and 1049′″ to provide the “yes” or “no” state visibleinformation directing the user by means of the “yes” state visibleinformation to either load a medicament 1011 into a cell 1033 or toverify that the medicament 1011 loaded in each cell 1033 is correct.Once loaded and verified, holder 1013′ may be closed with closure 1042in a conventional manner for blister-package-type containers asdescribed herein.

Use of sensor guide 1301, 1301′ is illustrated in FIGS. 54-72 whichrepresent exemplary screen displays of a type which could be displayedto a technician, pharmacist, or other user on video display 1125 forimplementation of system 1010, while FIGS. 73-91 represent exemplaryscreen displays displayed on video display 1125 for implementation ofsystem 1010′. The screen displays of FIGS. 54-91 are intended torepresent non-limiting examples as the type and number of screendisplays can be modified and the information provided in the screendisplays may be customized to meet the needs of the particular pharmacy,hospital, long-term care facility or other operator.

Referring then to systems 1010, 1010′, a user (e.g., a technician orpharmacist) may initiate use of system 1010, 1010′ in the same manner asfor system 10 by logging on to the system 1010, 1010′. Preferably,loading of holder 1013, 1013′ is performed by a technician whileverification of the loaded holder 1013, 1013′ is performed by aregistered pharmacist. (For simplicity and brevity, the person operatingsystem 1010, 1010′ is referred to as a “user.”) The user may log on viaa log-on screen 137 (FIG. 14) by means of keyboard 1127 entry of apassword, or by means of a biometric device 1130 as described inconnection with FIG. 14 with the result being that the user isrecognized as a being authorized.

Referring now to FIGS. 54 and 73, if a holder 1013, 1013′ is not alreadydocked at docking station 1015, 1015′ as shown in FIGS. 23 and 37, thena New Order screen 1355, 1355′ (FIGS. 54, 73) may be displayed on videodisplay 1125. The new Order screen 1355, 1355′ prompts the user toinitiate loading of a holder 1013, 1013′ for purposes of loadingautomatic dispensing machine 49 or for preparation of a self-containedcontainer 1013′, potentially in fulfilment of a prescription order.

Information which may be presented on New Order screen 1355, 1355′ caninclude an identification field 1357 identifying the operator name 1359(e.g., Red Cross Pharmacy). Optionally, the user name, date andtime-of-day on which holder 1013 is being loaded 1360 could be provided.Additional information which may be displayed in connection with NewOrder screen 1355, 1355′ is an Order field 1361, which displays allpending prescription orders awaiting attention. In the example of FIGS.54 and 73, a single prescription order 1363 is awaiting fulfillment.Each prescription order has previously been processed by PIS 1351 andreleased for fulfillment to controller 1017.

Order field 1361 may include a patient identifier and transaction code1365 (e.g., “ID: 218” “Single Patient_02_06_2013_3_18”) which indicatesthe transaction corresponding to loading of the holder 1013, 1013′ forrecord-keeping purposes. In other embodiments, the name of the personfor whom the prescription is intended may also be presented. New Orderscreen 1355, 1355′ may also show holders 1013, 1013′ available forfulfilment of the order, including the holder identifier 1369 (e.g.,“Tray Number 3”) for each holder 1013, 1013′. In the exemplary screendisplay examples of FIGS. 54-91, “tray” is used synonymously andinterchangeably with “holder” and “container.” Three holders 1013, 1013′indicated by 1370 are available to be loaded with medicaments 1011 tofulfill the prescription orders.

Preferably, the transaction code and all other information relating toloading and verification of holder 1013, 1013′ is stored in a database1371 on client computer 1349. Holder identifier 1369 may be any symbolor group of symbols capable of uniquely distinguishing one holder 1013,1013′ from another holder 1013, 1013′.

In the examples, holder identifier 1369 may be identical to anidentifier embedded in RFID tag-type identification element 1081 if suchan element 1081 is provided. In the examples, the holder identifier 1369is the number “3”. A unique identifier 1369 can be important if morethan one identical holder 1013 is used by the pharmacy, hospital,long-term care provider or other operator. For holder 1013′, uniqueidentifier 1369 is illustrated as number “3” as illustrated in FIG. 73.

The user then touches video display 1125 next to an order in Order field1361 to select the prescription order. In the examples of New Orderscreens 1355, 1355′ illustrated in FIGS. 54 and 73, there is a singleorder pending in each illustrated Order field 1361. In FIGS. 54 and 73,the “−” symbol 1372 indicates that the selected prescription order isbeing processed. Alternatively, another input device, such as a mouse1129 may be used to select the prescription order. The user furtherselects an available holder 1013, 1013′ for the prescription order bytouching display 1125 next to holder identifier 1369. The row next toholder identifier 1369 may become highlighted as illustrated in FIGS. 54and 73. The user then touches the Fill icon 1373 to start the loadingprocess.

Referring next to FIGS. 55 and 74, the next step in the exemplaryprocess is to physically get the holder 1013, 1013′ for fulfillment ofthe order. Once the Fill icon 1373 is touched, an instruction field 1375may appear on display 1125. The words “Please scan the bar code for thetray” 1377 may appear to prompt the user to scan bar code 1132 on holder1013, 1013′ with bar code reader 1131. Controller 1017 validates barcode 1132 and associates the holder 1013, 1013′ with the prescriptionorder in database 1371. The user may touch the “OK” icon 1379 followingthe scan to signal to controller 1017 that the bar code 1132 has beenread or controller 1017 may automatically move to the next step. If theholder 1013, 1013′ is not valid, then an error message (not shown) maybe displayed on display 1125 and the user must obtain the correct holder1013, 1013′ or otherwise correct the error before proceeding further.

Referring next to FIGS. 56 and 75, the next step in the exemplaryprocess is to select a container 1135 (FIGS. 53) of medicaments 1011 tobe loaded into holder 1013, 1013′. Instructions for the prescriptionorder residing in database 1371 include the exact type and quantity ofmedicament 1011 to be loaded into holder 1013. 1013′ and the cell 1033into which each medicament 1011 is to be loaded.

Instruction field 1381 may appear on display 1125 to prompt the user toselect the container 1135 holding one of the types of medicaments 1011to be loaded into holder 1013, 1013′ in accordance with the order. Theorder may require just a single type of medicament 1011 or pluraldifferent types of medicaments 1011. Instruction field 1381 may displayinformation identifying the type 1383 of medicament 1011 to be loadedinto holder 1013, 1013′ (e.g., “Fluoxetine HCL”) and the National DrugCode (NDC) 1385 associated with that type of medicament 1011 (e.g., the11 digit NDC “55111014701”). The words “Please scan the medicationbottle” 1387 may appear to prompt the user to scan the bar code 1133 oncontainer 1135.

In addition, a Medicament-identification field 1388 may appear withfurther information identifying the required medicament 1011 includingthe medicament type and strength 1389 (e.g., “Fluoxetine HCL Prozac 10mg”), FDA and customer NDC numbers 1391 (e.g., 11-digit NDC“55111014701” and 9-digit customer NDC “551110147”), medicament 1011quantity required 1393 (e.g., “1”), physical appearance 1395 of themedicament 1011 (e.g., “blue/obl/Fluoxetine 10 mg R147”), manufacturername 1397 (e.g., “DR. REDDY'S LAB”), expiration date and lot number 1399(“Assigned EXP: 2/7/2014” “Lot: C204817”).

Also in the examples, a holder-view field 1401 may appear in thebackground for the reasons described below. Holder-view field 1401 maybe a plan view graphic representation of a respective sensor guide 1301,1301′.

The user then utilizes bar code scanner 1131 to scan bar code 1133affixed to container 1135. The code corresponding to bar code 1133 istransmitted to controller 1017 which validates the code. The code may bevalidated, for example, by comparing the code embedded in bar code 1133with an expected code in database 1371 on client computer 1349 ofcontroller 1017 for the prescription order. If the container 1135 is notvalid, then an error message (not shown) is displayed on display 1125and the user must obtain the correct container 1135 or otherwise correctthe error before proceeding further. The “+” symbol 1402 indicates thatthe container 1135 has not yet been validated as correct for theprescription order.

Referring next to FIGS. 57 and 76, if medicament container 1135 is avalid container with the medicament 1011 required to fulfill theprescription order, then Filling screen 1403, 1403′ may be displayed toassist the user with loading of the required type of medicament 1011(e.g., Fluoxetine HCL in the examples) into holder 1013, 1013′. Holderview field 1401 is fully viewable on Filling screen 1403, 1403′. Holderview field 1401 includes a number next to each cell (e.g., 1-64 or 1-32)which corresponds to indicia 1323 next to opening 1317 on sensor guide1301, 1301′. In the example of Filling screen 1403, Holder view field1401 is a plan view of sensor guide 1301 and the 64 openings 1317 andaligned cells 1033 of holder 1013. In the example of Filling screen1403′, Holder view field 1401 is a generalized plan view of sensor guide1301′ and the arrangement of the 128 openings 1317 of sensor guide 1301′and the aligned cells 1033 of each separate holder 1013′. (i.e., ovalsare provided corresponding to the elongate “D” shaped cells 1033 ofholder 1013′) In FIG. 77, the terms “Card 1”, “Card 2”, “Card 3”, “Card4” refer to the position of each separate holder 1301′ which may bedocked at docking station 1015′.

In the examples, the Fluoxetine HCL medicament 1011 corresponding to thevalidated container 1135 is displayed in medicament-identification field1388. Information on any other medicaments 1011 to be loaded into holder1013, 1013′ may be turned off to avoid any possible confusion.

Filling screen 1403, 1403′ provides instructions to the user regardingwhich sensor guide 1301, 1301′ opening 1317 and cell 1033 eachFluoxetine HCL medicament 1011 is to be placed into in these examples.The instructions may include highlighting of each cell 1405corresponding to the opening 1317 and cell 1033 into which theFluoxetine HCL medicament 1011 is to be hand-loaded by the user. Thecontrast between the highlighted oval 1405 indicative of the “yes” stateand un-highlighted cells 1407 indicative of the “no” state (forconvenience only certain of the un-highlighted cells are indicated by1407) enables the user to easily identify the opening 1317 and cell 1033into which the Fluoxetine HCL medicament 1011 of the examples is to beplaced.

The instructions of Filling screen 1403, 1403′ may further include thequantity 1406 of medicament(s) 1011 to be placed into opening 1317 andcell 1033. This may be accomplished as illustrated in FIGS. 57 and 76 bydisplaying a number (e.g., “1”) within the highlighted cell 1405corresponding to the required opening 1317 and cell 1033 consistent withthe quantity “1” indicated by 1393. In the example of Filling screen1403, a quantity of one 10 mg Fluoxetine HCL is to be placed intoopening 1317 and cell 1033 identified by the number “5.” In the exampleof Filling screen 1403′, a quantity of one 10 mg Fluoxetine HCL is to beplaced into the holder 1013′ in the Card 1 position of docking station1015′ and the holder 1013′ opening 1317 and cell 1033 identified by thenumber “1.” For both Filling screens 1403, 1403′ of FIGS. 57 and 76,dash “−” symbol 1409 indicates that the prescription order is beingprocessed and that the medicament container 1135 was validated ascorrect. (In the screen displays, a dash “−” symbol indicates thatprocessing is taking place whereas a “+” symbol indicates thatprocessing is not taking presently occurring.) The “X” symbol 1411 in ornext to medicament-identification field 1388 indicate that themedicament 1011 has not yet been placed into opening 1317 and cell 1033.

Simultaneous with display of Filling screen 1403, 1403′, controller 1017causes docking station 1015, 1015′ to provide the visible information tothe user next to each opening 1317 and cell 1033 into which themedicament 1011 is to be placed. In the example of system 1010, this maybe accomplished by activating indicators 1049, 1049′, 1049″, and 1049′″next to opening 1317 number “5” of sensor guide 1301 and aligned cell1033 number “5” of holder 1013. Indicators 1049, 1049′, 1049″, and1049′″ for more than one opening 1317 and cell 1033 may besimultaneously activated if a medicament 1011 of the same type is to beplaced into more than one cell 1033 of the same holder 1013. In afurther embodiment, the indicators 1049, 1049′, 1049″, and 1049′″ forall openings 1317 and cells 1033 could be activated to provide the “no”state information while the indicators 1049, 1049′, 1049″, and 1049′″for the cell 1033 into which the medicament 1011 is to be placed couldbe deactivated, with the deactivated indicators providing the “yes”state information.

Referring to FIG. 76, in the example of system 1010′, controller 1017activates indicators 1049, 1049′, and 1049′″ next to opening 1317 number“1” of sensor guide 1301′ and aligned cell 1033 number “1” of holder1013′ for a holder 1013′ in the pockets 1229 a corresponding to Card 1.If the same type of medicament 1011 is to be placed into plural openings1317 and cells 1033, then indicators 1049, 1049′, 1049′″ for suchopenings 1317 and cells 1033 may be simultaneously activated asdescribed above.

Accordingly, the user is provided with visible information both onFilling screen 1403, 1403′ of display 1125 (FIGS. 57, 76) and fromvisible information sources on sensor guide 1301, 1301′ indicating theopening 1317 and cell 1033 into which the medicament 1011 is to beplaced. Filling screen 1403, 1403′ and indicators 1049, 1049′, 1049″,and 1049′″ make it possible for the user to correctly load themedicament 1011 without any reliance on paper instructions. The user cankeep her eyes on the medicament 1011, opening 1317, cell 1033, and thevisible information provided by indicators 1049, 1049′, 1049″, and1049′″ at the moment the medicament 1011 enters opening 1317 and cell1033 providing a high confidence level that the medicament 1011 has beenplaced into the correct cell 1033.

Next, and as illustrated in FIGS. 28-28A and 42-42A, the user utilizesthe visible information to actually hand-load medicament(s) 1011 intothe opening 1317 and cell 1033. In the examples, the user removes one 10mg Fluoxetine HCL medicament 1011 from container 1135. The user gripsthe medicament 1011 with her hand and fingers and positions themedicament 1011 just over the sensor guide opening 1317 and cell 1033number “5” of the holder 1013 docked at the docking station 1015 in theexample of system 1010 or into sensor guide opening 1317 and cell 1033number “1” in the example of system 1010′. The user gently drops themedicament 1011 into the opening 1317 and cell 1033. Preferably, themedicament 1011 should be released as close as possible to sensor guideopening 1317. Gentle dropping avoids “bouncing” which can occur when ahard medicament 1011 strikes a hard surface, such as shuttle 1055closing cell 1033. Bouncing could cause medicament 1011 to fall on thefloor or land in an incorrect cell 1033.

FIGS. 28-28A and 42-42A illustrate entry of a medicament 1011 into acell 1033. As illustrated, medicament 1011 first falls through opening1317 of sensor guide 1301, 1301′. Medicament 1011 momentarily breaks theIR beam generated by senders 1333 across opening 1331 onto receiver 1335causing a voltage drop which is detected by controller 1017 aspreviously described. A single breaking of the IR beam would indicatethat one medicament 1011 had been placed into an opening 1317 andcontroller 1017 would increment one count. A count is incremented orregistered for each medicament 1011 placed into opening 1317 and cell1033. In this way, a total count of medicaments 1011 placed into eachcell 1033 is created and stored in the database 1371 residing on clientcomputer 1349.

If the detected count matches the expected count for that cell 1033,then a record is created in database 1371 that the correct quantity ofmedicament 1011 was placed into the cell 1033. If no other cells 1033are required to be loaded with this type of medicament 1011, thencontroller 1017 may automatically change the appearance ofmedicament-identification field 1388 to replace the “X” symbol 1411 witha “ ” symbol 1415 to indicate that the medicament 1011 has been placedinto the cell 1033. Plus “+” symbol 1413 indicates that the medicament1011 required by Medicament ID field 1388 has been correctly loaded inthe expected cell 1033.

Controller 1017 may immediately move to the next type of medicament 1011to be loaded into holder 1013. Alternatively, the user may manuallytouch the Update icon 1417 which causes controller 1017 to move to thenext type of medicament 1011 to be loaded into holder 1013. In theexamples, this may be accomplished by deactivating indicators 1049,1049′, 1049″, and 1049′″ for, in the example, opening 1317 and cell 1033number “5” and by un-highlighting oval 1405 on Filling screen 1403,1403′. Then, indicators 1049, 1049′, 1049″, and 1049′″ for the nextopening 1317 and cell 1033 into which the next type of medicament 1011is to be loaded may be activated and the corresponding cell(s) onFilling screen 1403, 1403′ may be highlighted as previously described.This same process of indicator 1049, 1049′, 1049″, and 1049″″deactivating and activating and displaying an updated Filling screen1403, 1403′ can occur automatically without touching Update icon 1417 ifcontroller 1017 is programmed to operate automatically.

The foregoing process is repeated until all cells 1033 of holder 1013,1013′ have been loaded.

FIGS. 58 and 77 illustrate that the medicaments 1011 (i.e., Fluoxetine1389 and Furosemide 1389) displayed in the two separate Medicament IDfields 1388 have been loaded with processing completed as indicated bythe “+” 1413 and the operation completed “ ” symbols 1415. The user mayscroll up or down through the medicament-identification fields 1388using up/down scroll icons 1416 to confirm that a plus “+” symbol 1413and “ ” symbol 1415 are present to indicate that the each type ofmedicament 1011 has been placed into each opening 1317 and cell 1033 asrequired by the prescription order.

Referring further to FIGS. 58 and 77, once all cells 1033 have beenloaded, controller 1017 may cause “Tray Filled” icon 1419 to becomehighlighted and the user may touch Tray Filled icon 1419 to indicate tocontroller 1017 that the loading process has been completed. Touching ofTray Filled icon 1419 sends a signal to controller 1017 indicating thatloading of holder 1013, 1013′ has been completed.

Referring next to FIGS. 59 and 78, Filled screen 1420, 1420′ is nextdisplayed indicating the status is “filled” completing the loadingprocess. The status of holder “3” is indicated as having been filled asindicated by the word “Filled” 1422.

Each holder 1013, 1013′ may optionally be immediately verified by apharmacist or may be undocked and stored for subsequent pharmacistverification prior to transferring medicaments 1011 from loaded holder13 into automated dispensing machine 45 or affixing closure 1042 toholder 1013′. The status of the prescription order of Order field 1361in FIGS. 59 and 60 is indicated as “Incomplete” 1424 becauseverification has not yet occurred.

Sensor guide 1301, 1301′ further provides positive feedback tocontroller 1017 in the event that medicament 1011 is placed into thewrong opening 1317 and cell 1033 or if a greater or lesser quantity ofmedicaments 1011 than required has been placed into a cell 1033. Thefeedback is useful to help a user correct any errors that could occurwhen loading holder 1013, 1013′.

Referring to FIGS. 60 and 79, if a greater than expected quantity ofmedicaments 1011 are detected by sensor guide 1301, 1301′, then system1010, 1010′ enters an overcount mode. The signal provided by sensormodule 1325 increments or registers counts by controller 1017 for theopening 1317 and cell 1033. In an overcount mode, controller 1017 maycause Overcount warning screen 1421, 1421′ to be immediately displayedwith the cell 1405 corresponding to the opening 1317 and cell 1033including the excess quantity of medicaments 1011 surrounded by ablinking box 1423. An Error field 1425 including a text message 1427describing the overcount error can be displayed.

In the examples of FIGS. 60 and 79, the text message 1427 informs theuser that the quantity of medicaments 1011 in the cell 1033 designatedby number “5” exceeds the expected count by one medicament 1011. Inaddition, controller 1017 may blink the indicators 1049, 1049′, 1049″,and 1049′″ for the opening 1317 and cell 1033 including the overcount toindicate to the user the opening 1317 and cell 1033 requiring attention.

Referring further to FIGS. 60 and 79, in response to the Overcountwarning screen 1421, 1421′, the user can elect to correct the errorimmediately or can elect to correct the error upon completion of loadingall medicaments 1011 into holder 1013, 1013′. In the examples, the usercan touch the Correct Now icon 1429 or the Correct Later icon 1437.

FIGS. 61 and 80 may next be displayed responsive to touching the CorrectNow icon 1429. Controller 1017 may cause video display to displayCorrection field 1431 with instructions 1433 for correcting the error.In the examples, Correction field 1431 prompts the user to place thesensor guide 1301, 1301′ in the storage position of FIGS. 24 and 38 andto inspect cell 1033 number “5” for the one medicament 1011 overcount.Once the error is corrected, the “Resume” icon 1435 may be touchedindicating to controller 1017 that the error has been corrected and toproceed with loading the next cell 1033. Controller 1017 may updatedatabase 1371 to indicate that the error has been corrected. The usercan then proceed to load the next cell 1033. Or, if a different type ofmedicament 1011 is to be loaded, controller 1017 can then cause displayof the next Filling screen 1403, 1403′ so that the user can load thenext type of medicament 1011 into holder 1013, 1013′.

Referring again to FIGS. 60 and 79, as an alternative to immediatecorrection of the overcount error, the user can elect to touch CorrectLater icon 1437 to correct the error upon completion of loading allmedicaments 1011 into holder 1013, 1013′. FIGS. 62 and 82 illustrateinstructions which may be displayed if the Correct Later icon 1437 isselected. Once all cells 1033 have been loaded, Correction field 1439(FIGS. 62, 82) may appear with instructions for correcting the previouserror to the cell 1033 identified by number “5”. In the examples,Correction field 1439 prompts the place sensor guide 1301, 1301′in thestorage position (FIGS. 24, 38) and to inspect the cell 1033 identifiedby number “5” for a single medicament 1011 overcount. Once the overcounterror is corrected, the user touches the Resume icon 1441.

Referring now to FIGS. 63 and 82, if more than one error occurred, thencontroller 1017 may display Warning field 1443 notifying the user thatanother cell 1033 requires error correction. In the examples,instructions 1445 in Warning field 1443 prompt the user to correct anovercount in the cell 1033 designated by number “6”. The user may touchOK icon 1447 whereupon Correction field 1439 (FIGS. 62, 81) is displayedprompting correction of the overcount error as preciously described. Ifthe user does not correct the errors, then controller 1017 deactivatessystem 1010, 1010′ requiring the user to take further action to correctthe error or start over.

Referring to FIGS. 64 and 83, if fewer than the expected quantity ofmedicaments 1011 are detected by sensor guide 1301, 1301′ and controller1017, then system 1010, 1010′ enters an undercount mode. In anembodiment, an undercount can occur if the required quantity ofmedicaments 1011 is not detected as having been placed into the opening1317 and cell 1033 and the user touches the Update icon 1417 (FIGS. 57,76) to move to loading the next type of medicament 1011. In anotherembodiment in which controller 1017 automatically moves to the nextmedicament type (i.e., without touching Update icon 1417), an undercountcould occur if the required quantity of medicaments 1011 is not detectedas having been placed into the opening 1317 and cell 1033 within apredetermined time. A timer decremented by controller 1017 can be usedto determine whether the predetermined time has elapsed before detectionof the required quantity of medicaments 1011.

Referring further to FIGS. 64 and 83, in the event of an undercount,controller 1017 may cause Undercount warning screen 1449, 1449′ to bedisplayed and can cause the cell 1405 corresponding to the opening 1317and cell 1033 including the undercount to be surrounded by a blinkingbox 1423 in the same manner as described for the overcount error mode.An Error field 1455 including a text message 1457 describing theundercount error and prompting addition of the required quantity ofmedicaments 1011 can be displayed. In the examples, the text message1457 prompts the user to add one medicament 1011 to the opening 1317 andcell 1033 designated by number “5”. In addition, controller 1017 mayblink the indicators 1049, 1049′, 1049″, and 1049′″ for the opening 1317and cell 1033 including the undercount to indicate to the user theopening 1317 and cell 1033 requiring attention.

In response, the user adds the required quantity of medicament(s) 1011to the opening 1317 and cell 1033 causing detection of the addedmedicament(s) 1011 by sensor module 1325 and controller 1017incrementing or registering the required counts and updating of thedatabase 1371 for that cell 1033 to reflect loading of the correctquantity of medicaments 1011. The user then touches the Resume icon 1451indicating to controller 1017 that the error has been corrected and toproceed with loading the next cell 1033. Controller 1017 may updatedatabase 1371 to indicate that the error has been corrected.

While not illustrated in the figures, systems 1010, 1010′ may beconfigured to permit correction of the undercount error upon completionof loading all medicaments 1011 into holder 1013, 1013′ in the samemanner as previously described in connection with correction of theovercount error, but with the screen displays and information modifiedto indicate an undercount error. If the user does not correct theundercount error, then controller 1017 deactivates system 1010, 1010′requiring the user to take further action to correct the error or startover.

Referring now to FIGS. 65-66 and 84-85, an incorrect cell error mode isentered if the medicament 1011 is accidentally placed in an incorrectopening 1317. During routine loading, the opening 1317 and cell 1033into which a medicament 1011 is to be placed is indicated by Fillingscreens 1403, 1403′ and by indicators 1049, 1049′, 1049″, and 1049′″ forthe opening 1317 and cell 1033 as previously described.

If a medicament 1011 is detected by sensor guide 1301, 1301′ andcontroller 1017 as having been placed into an opening 1317 and cell 1033other than as indicated, then controller 1017 may cause Incorrect Cellwarning screen 1453, 1453′ to be displayed. Controller 1017 can furthercause both the cell 1405 corresponding to the correct opening 1317 andcell 1033 and the incorrect cell 1454 corresponding to the opening 1317and cell 1033 into which the medicament 1011 was incorrectly placed tobe surrounded by a blinking box 1423 in the same manner as described forthe overcount and undercount error modes. An Error field 1458 includinga text message 1460 describing the undercount error and promptingaddition of the required quantity of medicaments 1011 can be displayed.

Since an incorrect cell error should be corrected immediately, thecorrect later option for the overcount and undercount modes is not beavailable for the incorrect cell error correction mode. The Resume icon1459 is touched to correct the error.

FIG. 66 or 85 may next be displayed responsive to touching the Resumeicon 1459 including Correction field 1461 with instructions 1463 forcorrecting the error. In the examples, Correction field 1461 prompts theuser to place the sensor guide 1301, 1301′ in the storage position ofFIGS. 24 and 38 and to inspect cell 1033 numbers 5 and 8. In theexamples, the instructions 1463 inform the user that a medicament 1011intended for cell number “5” was incorrectly placed in cell number 8.

In response, the user places the sensor guide 1301, 1301′ in the storageposition (FIGS. 24, 38) and reaches into the cell 1033 with her fingersto remove the incorrect medicament 1011 from cell number 8. The user canthen touch the Resume icon 1465 indicating to controller 1017 that theerror has been corrected and to proceed with loading the next cell 1033.Controller 1017 may update database 1371 to indicate that the error hasbeen corrected. The user can then proceed to load the next cell 1033.Or, if a different type of medicament is to be loaded, controller 1017can then cause display of the next Filling screen 1403, 1403′ so thatthe user can load the next type of medicament 1011 into holder 1013,1013′.

Referring now to FIG. 13, a storage cabinet 169 may optionally beprovided to store one or more holder 1013, 1013′ in the same manner asdescribed in connection with system 10 thereby facilitating loading andverification of multiple holders.

As with systems 10, 10′, each loaded holder 1013, 1013′ of systems 1010,1010′ can be verified by a user who is a registered pharmacist to ensurethat each cell 1033 has been loaded with the correct medicament 1011.The verification process preferably occurs without any need for use ofsensor guide 1301, 1301′ and sensor guide 1301, 1301′ is preferably inthe storage position illustrated in FIGS. 23 and 38 during verification.It will be apparent that verification for systems 1010, 1010′ may beessentially the same as for systems 10, 10′.

Referring now to FIGS. 67 and 86, verification begins by entry into averification mode and display of Verification start screen 1471, 1471′.Holder 1013, 1013′ may be docked at docking station 1015, 1015′following loading. Alternatively, holder 1013, 1013′ may be retrieved,for example, from storage cabinet 169, and then docked at dockingstation 1015, 1015′ for verification.

The information which may be presented on Verification start screen1471, 1471′ may be essentially identical to that displayed in connectionwith New Order screens 1355, 1355′ and Filling screens 1403, 1403′. Forconvenience and simplicity, reference numbers for information displayedon New Order screens 1355, 1355′ and Filling screens 1403, 1403′ areused again to identify corresponding fields of information onVerification screens 1471, 1471′. Verification start screens 1471, 1471′may include an identification field 1357 identifying the operator name1359 (e.g., Red Cross Pharmacy). Optionally, the user name, date andtime-of-day on which holder 1013 is being loaded 1360 could be provided.Additional information which may be displayed in connection withVerification screen 1471, 1471′ is an Order field 1361 which displaysall pending holders 1301, 1301′ awaiting verification.

In the examples of FIGS. 67 and 86, a single order 1363 is awaitingverification. Order field 1361 may include a transaction code 1365(e.g., “ID: 6237”) which indicates the transaction corresponding toloading of the holder 1013, 1013′ for record-keeping purposes and mayindicate the quantity 1367 of holders 1013, 1013′ used to fulfill theprescription order. Verification screen 1471, 1471′ may also show theholder identifier 1369 (e.g., “Tray Number 1”) for each holder 1013,1013′. The status of the prescription order of Order field 1361 in FIGS.67 and 86 is indicated as “Incomplete” 1424 because verification has notyet occurred.

The Verification start screen 1471, 1471′ prompts the user to initiateverification of a holder 1013, 1013′. The user then selects the holder1301, 1301′ for verification by touching video display 1125 next to theorder in Order field 1361 or by another input device, such as a mouse1129. The user then touches the Check icon 1473 to start theverification process.

Referring next to FIGS. 68 and 87, Verification screen 1475, 1475′ maybe displayed for the selected holder 1013, 1013′. In the examples,Verification screen 1475, 1475′ preferably includes holder-view field1401 with a plan view of respective holders 1013, 1013′.

In addition, Medicament-identification field 1388 may appear for eachmedicament 1011 expected to be in holder 1013, 1013′ to assist the userwith the verification. Medicament-identification field 1388 may includeinformation identifying one type of the loaded medicaments 1011including the medicament type and strength 1389 (e.g., “Naproxen Anaprox375 mg”), FDA and customer NDC numbers 1391 (e.g., 11-digit NDC“00093014801”), medicament 1011 quantity 1393 expected to be loaded inthe holder (e.g., “24”), physical appearance 1395 of the medicament 1011(e.g., “Pch Obl Tb 148”), manufacturer name 1397 (e.g., “TEVA”),expiration date and lot number 1399 (e.g., “Assigned EXP: 12/15/2013”“Lot: J67934461”).

A second Medicament-identification field 1388 may include informationidentifying a second type of the loaded medicaments 1011 expected to bein holder 1013, 1013′ including the medicament type and strength 1389(e.g., “Oxycodone HCL 5 mg), FDA and customer NDC numbers 1391 (e.g.,11-digit NDC “00406055201”), medicament 1011 quantity 1393 expected tobe loaded in the holder (e.g., “26”), physical appearance 1395 of themedicament 1011 (e.g., “Wht Rnd Tb 0552”), manufacturer name 1397 (e.g.,“Mallinckrodt”), expiration date and lot number 1399 (“Assigned EXP:12/1/2018” “Lot: ZJ7890321”). Plus “+” symbol 1402 indicates thatverification of the medicament 1011 of Medicament ID field 1388 has notyet begun.

Preferably, the transaction code and all other information relating toloading and verification of holder 1013, 1013′ is stored in a database1371 on client computer 1349.

In order to verify that each cell 1033 holds the correct medicament1011, the user simply selects the Medicament-identification field 1388to be verified by touching the screen display 1125 next to the field1388 or by using another input device such as a mouse 1129 or keyboard1127.

Referring next to FIGS. 69 and 88, Verification screen 1475, 1475′ maybe displayed responsive to selection of one of theMedicament-identification fields 1388. FIGS. 69 and 88 show examples ofdisplayed information for verification of a total of 16 Naproxen tabletspreviously loaded into the openings 1317 and cells 1033 indicated by thehuman-readable indicia 1323 for the cells numbered “1, 4, 5, 7, 9, 10,13, 16, 19, 21, 22, 24, 27” of holder 1013 and the single Naproxenloaded in cell numbered “1” of holder 1013′. Selection of the Naproxentablets for verification is also indicated in the examples byhighlighting the cells 1467 expected to include the Naproxen andhighlighting the Medicament-identification field 1388 for Naproxen. Dash“−” symbol 1409 indicates the Medicament-identification field 1388 isbeing processed for verification. A reference image 1469 may bedisplayed to the user to assist with the verification process. TheMedicament-identification field 1388 associated with the Oxycodone HCLmedicaments 1011 can be turned off during verification of the Naproxenin the examples.

Also upon selection of the exemplary Medicament-identification field1388 for the Naproxen, controller 1017 again selectively activates eachindicator for the cell(s) 1033 to be verified by the pharmacist. In theexample of system 1010, indicators 1049, 1049′, 1049″ of docking station1015 and holder 1013 are activated and in the example of system 1010′indicators 1049, 1049′ of docking station 1015′ are activated. In theexamples, each other indicator 1049, 1049′, 1049″ is inactive.

As with the loading process illustrated in FIGS. 28-28A, 42-42A, 57 and76, this pick-to-light/place to light capability enables the user torapidly confirm that the correct medicament 1011 has been loaded intothe correct cell 1033 without the necessity for reliance on writtenverification instructions. The user can quickly look with her eyes intoeach cell 1033 and can see the medicament 1011 in the cell 1033. Theuser can compare the physical appearance of each medicament 1011 in eachindicated cell 1033 without the necessity of reliance solely on writteninstructions. This process is facilitated by presentation of thereference image 1469 as the user can quickly compare the appearance ofthe medicament 1011 on screen Verification screen 1475, 1475′ with theappearance of the medicament(s) 1011 in each highlighted cell 1033associated with the activated indicators 1049, 1049′, 1049″.

Selection of the Update icon 1477 completes verification forMedicament-identification field 1388 and the exemplary Naproxen. Onceall cells 1033 associated with a Medicament-identification field 1388are verified, the user then selects the next Medicament-identificationfield 1388 to be verified. This process is repeated until allmedicaments 1011 have been verified as called for by Verification screen1475, 1475′.

Referring next to FIGS. 70 and 89, once all Medicament-identificationfields 1388 and medicaments 1011 are verified, controller 1017 displaysa Barcode scan Field 1480 with instructions prompting the user to scan abar code 1132 on the holder 1013, 1013′ with bar code scanner 1131.Scanning of the bar code 1132 and touching the OK icon 1481 sends asignal to controller 1017 indicating to system 1010, 1010′ that holder1013 has been fully verified and that the medicament 1011 contents arein the correct cells 1033 ready for use with automated dispensingmachine 45 or that holder 1013′ has been fully verified and that themedicament 1011 contents are in the correct cells 1033 and that holder1013′ is ready to be sealed by closure 1042. Plus “+” symbol 1480indicates that the medicaments 1011 of Medicament-identification field1388 are no longer being processed and the symbol 1482 indicates thatthe medicaments of Medicament-identification field 1388 have beenverified and the records of database 1371 are updated accordingly.

Referring next to FIGS. 71 and 90, controller 1017 displays a Digitalsignature field 1483 with instructions prompting the user to digitallysign the holder creating a record in database 1371 of the userresponsible for the verification. The user can enter a digital signatureby keying in her user name in the user name field 1485 and keying in herpassword in the password field 1487. Alternatively, a biometric prompt1489 prompts the user to place her thumb on biometric scanner 1130. Thebiometric scan serves as the digital signature.

Referring to FIGS. 72 and 91, Verification complete screen 1491, 1491′may be displayed. Information identifying the prescription order mayappear identical to that from Verification start screen 1471, 1471′(FIGS. 67, 86). The status of the prescription order in Order field 1361may be indicated as Complete 1492 indicating that it has been verifiedas correct and the status of the holder 1013, 1013′ may be indicated asComplete 1494 confirming that the medicaments 1011 in holders 1013,1013′ have been verified as correct.

A record may be made of the verified medicament 1011 contents of holder1013, 1013′ cells 1033 which may be stored in database 1371 residing oncontroller 1017. Such a record is useful in further confirming that thecorrect medicaments 1011 were loaded in holder 1013, 1013′. Eachverified holder 1013 can then be stored in cabinet 169 awaiting use, orthe holder 1013 and its medicament 1011 contents can be taken directlyto automated dispensing machine 45 for immediate loading of medicaments1011 into exception storage apparatus 43. Holder 1013′ is preferablyimmediately sealed with closure 1042 and is labeled 1044 withpatient-specific information or other identifying information if holder1013′ is not intended for a specific patient.

Holder 1013 of system 1010 may be utilized to transfer the organizedmedicaments 1011 in holder cells 1033 to an exception storage apparatus43 of exemplary automated dispensing machine 45 of the same type asdescribed above in connection with FIGS. 18, 19, 20, 21A, 21B, and 21C.For convenience and brevity, the structure and operation of exemplaryautomated dispensing machine 45 is incorporated herein by reference andwill not be fully described here in connection with holder 1013. Anexemplary automated dispensing machine 45 which may be used with holder1013 is a model ATP 320, 371, or 384 dispensing machine available fromChudy Group, LLC of Powers Lake, Wis.

Holder 1013 is a lightweight portable device which may be convenientlyloaded at a workstation separate from automated dispensing machine 45.This permits holder 1013 to be loaded at a time and sequence in the workday that is convenient to the pharmacy. After loading and optionalverification, holder 1013 may be easily carried by a user from theworkstation or a storage cabinet 169 to exception storage apparatus 43so that the medicaments 1011 can be accurately, quickly and easily,transferred to exception storage apparatus 43 and automated dispensingmachine 45. If automated dispensing machine 45 must be shut down (i.e.,deactivated to permit the transfer of medicaments 1011 to exceptionstorage apparatus 43, then the rapid transfer of medicaments 1011 madepossible by use of holder 1013 minimizes that downtime in the samemanner as described above for holder 13. The transferred medicaments1011 may then be packaged by automated dispensing machine 45 intoseparate pouches 202 formed (e.g., by heat-sealing or sonic welding) ina web of packaging material 204 in the same manner as illustrated inFIG. 22.

Referring then to Figures18-21C, exception storage apparatus 43 is adrawer or tray-like device which can be pulled out from cabinet 191 ofautomated dispensing machine 45. When exception storage apparatus 43 ispulled out, automated dispensing machine 45 is temporarily shut down andis out of service and unavailable to fill prescription orders anddispense requests. Exception storage apparatus 43 illustrated in FIGS.19-20 can be described as having a somewhat flat and narrowconfiguration with a plurality of cells 41 provided therein. Each cell41 of exception storage apparatus 43 is capable of storing onemedicament 1011, or a small quantity of medicaments 1011, as illustratedin FIGS. 21A-22. In the example, cells 41 include 64 total cells groupedin four rows of 16 cells, the same pattern as cells 1033 of holder 1013.

As described above, medicaments 1011 transferred to cells 41 ofexception storage apparatus 43 cells 41 are indexed for movement along atrack (not shown) in exception storage apparatus 43. Cells 41 areindexed forward along the track toward an opening (not shown) in thebottom of apparatus 43 so that the contents of each cell 41 fall througha cell bottom opening (not shown) and to a packaging device withinautomated dispensing machine 45 through chutes, hoppers or other guidestructure, or by a mechanical device such as an auger. Medicaments 1011may be discharged from cells 41 by any other suitable means including amovable gate (not shown) over a cell bottom outlet (not shown), or by asolenoid, air-powered actuator, air-jet, or mechanical arm which ejectsthe medicament through an upper cell inlet 209 of the type shown in FIG.19A. The medicaments 1011 fall via chutes, guides to a packaging deviceor are directed to packaging device by mechanical means (e.g. an auger).

Also as described above, exemplary automated dispensing machine 45includes a pouch-package-type packaging apparatus (not shown) within alower portion of cabinet 191. Alternatively, packaging apparatus capableof packaging medicaments 1011 into other container types (e.g., bottles,vial, blister packages) may be utilized. A pouch-package-type packagingdevice includes a form-fill-seal packaging device. Packaging apparatusis preferably a “form-fill-seal” packaging device which forms a package(i.e., a pouch) in a web of packaging material 204, fills the package202 with the medicament(s), and seals the package 202 forming aplurality of discrete packages 202, or pouches.

In the examples, one or more medicament 1011 discharged from thecassette-type storage apparatus (not shown) of automated dispensingmachine 45 described previously or exception storage apparatus 43 isloaded into separate pouches 202 formed (e.g., by heat-sealing or sonicwelding) in a web of packaging material 204 as illustrated in FIG. 22.Information can be printed on each pouch 202 by a printer (not shown)associated with automated dispensing machine 45 and such information caninclude the patient's name 206, medicament name and quantity 208,prescription number 210, date 212, instructions for taking themedicament 214 (such as time of day the medicament is to be taken) andmachine-readable indicia 216 (such as a bar code) representative of theaforesaid information. As above, pouch packages 202 are ideal for use inadministering medication regimens because the exact medicaments 1011 tobe taken at a given time can be packaged together in a single pouchpackage 202, and the pouches can be organized and labeled in the exactorder in which each medicament 1011 is to be taken, for example,morning, noon and evening.

Transfer of medicaments 1011 from holder cells 1033 to exception storageapparatus 43 is accomplished in the same manner as described inconnection with FIGS. 21A-21C. Holder 1013 may be placed directly on topof exception storage apparatus 43 in the same manner as shown in FIG. 20and FIGS. 21A-21C with each cell 1033 and 41 completely aligned and inregistry. As previously described, holder 1013 and exception storageapparatus 43 each have 64 total cells 1033, 41 grouped in four rows of16 cells. Human-readable indicia 211 is preferably provided on exceptionstorage apparatus 43 (FIG. 19A) so that each cell 1033 on holder 1013has the same indicia 1047 as indicia 211 on exception storage apparatus43. The cell 1033 pattern and indicia 1047 of holder 13 is mostpreferably identical to the cell 41 pattern and indicia 211 of exceptionstorage apparatus 43.

Referring again to FIGS. 20 and 21A-21C, the holder 1013 which ispreferably verified as correct is taken to exception storage apparatus43 of automated dispensing machine 45 by a user or pharmacist. Holder1013 is set on top of exception storage apparatus 43 in the same manneras illustrated in FIG. 20. Legs 1051, 1053 position holder 1013 overexception storage apparatus 43 as shown, for example, in the same manneras holder 13 in FIGS. 21A-21C to ensure that holder 1013 is in thecorrect orientation on exception storage apparatus 43 with correctalignment of cells 1033, 41. Once aligned, holder 1013 is initially inthe position shown in FIG. 21A in the same manner as holder 13.

If holder 1013 includes an identification element 1081 and automateddispensing machine 45 includes an identification element detector 84,then the detector 84 may identify holder 1013. If the correct holder1013 is positioned over exception storage apparatus 43, the user isgiven a prompt signal by video display 201 to proceed with transfer ofthe medicaments 1011. If an incorrect holder 1013 is positioned overexception storage apparatus 43, then display 201 prompts the user to nottransfer the medicaments 1011 and may present an error message and/oralarm. In addition, system 1010 may deactivate automated dispensingmachine 45 preventing further operation until the correct holder 1013 isin place or the user overrides the system 1010.

Prior to medicament 1011 transfer and as shown in FIG. 21A, shuttlemember 1055 is in the same position as shuttle member 55 in a “closed”position with cell 1033 outlets 1039 covered by shuttle member 1055 inthe same manner as cells 33 are closed in FIG. 21A. Medicaments 1011cannot exit cells 1033 in this closed position.

Next, the user grasps pull 1061 and moves shuttle member 1055 in thesame manner as pull 61 is moved in the direction of arrow 217 in FIG.21B. Translating movement of shuttle member 1055 partially opens celloutlets 1039 as openings 1059 in shuttle member 1055 are aligned withcell outlets 1039. As a result, medicaments 1011 begin to fall by meansof gravity into the aligned cells 41 of exception storage apparatus 43in the same manner as medicaments 11 fall from cells 33 in FIG. 21B.

Finally, the user moves shuttle member 1055 fully to the “open” positionin the same manner as shuttle member 55 is moved in the direction ofarrow 217 in FIG. 21C. Cells 1033 are fully open in this positioncausing medicaments 1011 in cells 1033 to fall into the correspondingcells 41 of exception storage apparatus 43 in the same manner asmedicaments 11 fall into exception storage apparatus 43 illustrated inFIG. 21C. Exception storage apparatus 41 is now correctly loaded and isready for dispensing and packaging of the slow mover medicaments 1011stored in cells 41. This loading process, which is the same as shown inFIGS. 21A-21C in the example, is very rapid (less than one minute) andenables automated dispensing machine 45 to be quickly returned toservice.

Holder 1013′ of system 1010′ is the container in which medicaments 1011are ultimately delivered to the patient. Before or after loading ofholder 1013′, a label 1044 may be applied to holder 1013 as previouslydescribed (FIG. 44). Once loaded and verified, holder 1013′ may beclosed with closure 1042 in a conventional manner forblister-package-type containers.

Systems 1010, 1010′ accurately and rapidly enable loading of medicaments1011 in the exact order in which the medicaments 1011 are to be loadedinto exception storage apparatus 43 or packaged in a container (e.g., ablister-package-type holder 1013′) for use by a specific patient or foranother purpose. Sensor guide 1301, 1301′ provides the option forpositive feedback indicative that the medicaments 1011 were loadedcorrectly or that an error has occurred. The use of indicators 1049,1049′, 1049″, and 1049′″ permits a user (e.g., a technician orpharmacist) to load and optionally verify the contents of holder 1013,1013′ without having to take his or her eyes off of the holder 1013,1013′ to read instructions thereby reducing the amount of time needed toload and optionally verify each holder 1013, 1013′.

Providing the correct medicament 1011 to the patient provides for abetter level of patient care. Time saved in the fulfillment ofprescription orders can be utilized for other purposes, such ascounseling patients. Thus, systems 1010, 1010′ provide the opportunityfor improvements in patient care.

While the principles of this invention have been described in connectionwith specific embodiments, it should be understood clearly that thesedescriptions are made only by way of example and are not intended tolimit the scope of the invention.

1.-14. (canceled)
 15. A method for loading medicaments into a blisterpackage, the method comprising: providing a blister package, the blisterpackage having walls defining plural cells arranged in a pattern, eachcell having a cell upper opening; docking the blister package in adocking station, the docking station including a plurality ofcell-receiving pockets arranged in the pattern such that the blisterpackage cell walls are nested within the pockets when docked; providinga controller operatively associated with the docking station and withvisible information sources, the visible information sources configuredto generate visible information indicating at least yes and no statessuch that the visible information is viewable on the docked blisterpackage to indicate the cell into which each medicament is to be loaded;via the controller, generating with the visible information sources thevisible information such that the yes state information is visibleproximate a cell of a docked blister package into which a medicament isto be loaded; loading the medicament into the cell proximate the yesstate information through the upper opening of the cell; repeating thegenerating and loading steps until all required medicaments are loadedinto the cells of the blister package; and removing the docked blisterpackage from the docking station with the medicaments therein.
 16. Themethod of claim 15 wherein the blister package cell walls have across-sectional shape and the pockets have a cross-sectional shapecomplementary thereto to facilitate the nesting of the blister packagewith the docking station.
 17. The method of claim 15 wherein the dockingstation pockets are arranged in a plurality of pocket groups, eachpocket group being capable of receiving a separate blister packagethereby enabling a plurality of the blister packages to be dockedsimultaneously at the docking station.
 18. The method of claim 15further including sealing the cell upper openings with a closure aftermedicaments are loaded in the cells to provide a self-contained, sealedcontainer.
 19. The method of claim 15 wherein the docking stationfurther includes circuitry connecting the docking station with thecontroller and the visible information sources enabling control of thevisible information.
 20. The method of claim 15 wherein the visibleinformation sources radiate visible light.
 21. The method of claim 20wherein each visible information source includes an energizable lightsource.
 22. The method of claim 21 wherein the light source isconfigured to provide multi-colored light.
 23. The method of claim 15wherein a sensor guide associated with the docking station detectswhether the medicament is placed into a cell indicated to have a yesstate.
 24. The method of claim 23 wherein the sensor guide detects ifmedicament is placed in a cell other than the cell having a yes stateand the controller generates a signal if the medicament is placed a cellother than the cell having a yes state.
 25. A method for loadingmedicaments into a blister package, the method comprising: providing ablister package, the blister package having walls defining plural cellsarranged in a pattern, each cell having a cell upper opening; dockingthe blister package in a docking station, the docking station includinga plurality of cell-receiving pockets arranged in the pattern such thatthe blister package cell walls are nested within the pockets whendocked; providing a controller operatively associated with the dockingstation and with visible light sources, the visible light sourcesconfigured to generate visible light indicating at least yes and nostates such that the visible light is viewable on the docked blisterpackage to indicate the cell into which each medicament is to be loaded;via the controller, generating with the visible light sources thevisible light such that the yes state indication is visible proximate acell of a docked blister package into which a medicament is to beloaded; loading the medicament into the cell proximate the yes stateindication through the upper opening of the cell; repeating thegenerating and loading steps until all required medicaments are loadedinto the cells of the blister package; removing the docked blisterpackage from the docking station with the medicaments therein; andsealing the cell upper openings with a closure after medicaments areloaded in the cells to provide a self-contained, sealed container.
 26. Amethod for verifying the locations of medicaments in a blister package,the method comprising: providing a blister package, the blister packagehaving walls defining plural cells arranged in a pattern, each cellhaving a cell upper opening through which a medicament may be loadedinto the cell, docking the blister package in a docking station, thedocking station including a plurality of cell-receiving pockets arrangedin the pattern such that the blister package cell walls are nestedwithin the pockets when docked, providing a controller operativelyassociated with the docking station and with visible informationsources, the visible information sources configured to generate visibleinformation indicating at least yes and no states such that the visibleinformation is viewable on the docked blister package; via thecontroller, generating with the visible information sources the visibleinformation such that the yes state information is visible proximate acell of a docked blister package in which a medicament is to be located;verifying the presence of the medicament in the cell proximate the yesstate information; repeating the generating and verifying steps untilall required medicaments are verified as accurately loaded in the cellsof the blister package; and removing the docked blister package from thedocking station with the medicaments therein.
 27. The method of claim 26wherein the blister package cell walls have a cross-sectional shape andthe pockets have a cross-sectional shape complementary thereto tofacilitate the nesting of the blister package with the docking station.28. The method of claim 26 wherein the docking station pockets arearranged in a plurality of pocket groups, each pocket group beingcapable of receiving a separate blister package thereby enabling aplurality of the blister packages to be docked simultaneously at thedocking station.
 29. The method of claim 26 further including sealingthe cell upper openings with a closure after the verifying step toprovide a self-contained, sealed container.
 30. The method of claim 26wherein the visible information sources radiate visible light.
 31. Themethod of claim 30 wherein each visible information source includes anenergizable light source.
 32. The method of claim 31 wherein the lightsource is configured to provide multi-colored light.